Written by Revati Krishnan | Last published at: July 28, 2022


Overview


The tooth is one of the most individual and complex anatomical as well as histological structures in the body. The tissue composition of a tooth is only found within the oral cavity and is limited to the dental structures. Each tooth is paired within the same jaw, while the opposing jaw has teeth that are classified within the same category.

However they are not grouped according to structure, but rather by function. They are seated within the upper and lower alveolar bone in the maxilla and mandible respectively and this exclusive type of joint is known as gomphosis.

Different Parts of a Tooth


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Types of Teeth


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The human dentition is composed of two sets of teeth – primary and permanent. Teeth are organized into two opposing arches – maxillary (upper) and mandibular (lower). These can be divided down the midline (mid-sagittal plane) into left and right halves. Teeth are positioned in alveolar sockets and connected to the bone by a suspensory periodontal ligament.

The primary dentition is composed of 20 teeth, with 10 in each arch. There are five teeth in each quadrant, composed of two incisors (central and lateral), a canine, and two molars. These teeth are referred to as letters A, B, C, D and E. The primary teeth begin to erupt at 6 months of age.

The permanent dentition is composed of 32 teeth with 16 in each arch. There are eight teeth in each quadrant, composed of two incisors (central and lateral), a canine, two premolars, and three molars. These teeth are referred to as numbers, 1 (central incisor) to 8 (3rd molar or ‘wisdom’ tooth). The permanent teeth begin to erupt, and replace the primary teeth, at 6 years of age. The permanent teeth complete eruption by approximately age 13 years, with the exception of the 3rd molar ‘wisdom’ teeth, which usually erupt by the age of 21 years.

Teeth Surfaces


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A tooth has five surfaces: one that faces the inner lip or cheek, one that faces the tongue, the chewing surface and the two that are next to other teeth. The surface of a tooth is named depending on the location of the tooth, and teeth are named according to their location in the mouth.

Tooth Numbering


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The American Dental Association Universal Numbering System is a tooth notation system primarily used in the United States. Teeth are numbered from the viewpoint of the dental practitioner looking into the open mouth, clockwise starting from the distalmost right maxillary teeth. The uppercase letters A through T are used for primary teeth and the numbers 1 - 32 are used for permanent teeth. The tooth designated "1" is the maxillary right third molar ("wisdom tooth") and the count continues along the upper teeth to the left side. Then the count begins at the mandibular left third molar, designated number 17, and continues along the bottom teeth to the right side. Each tooth has a unique number or letter, allowing for easier use on keyboards.

Common Tooth Conditions


Written by Revati Krishnan | Last published at: August 11, 2022


Dentists


A dentist is an accredited medical professional who specializes in the care of teeth, gums, and mouths. As with most medical professions, a keen eye for detail, comprehensive medical understanding, manual dexterity, and strong interpersonal skills are important. Dentists deal with procedures that involve actual manipulation of the teeth or gums. Dentists have also evolved to provide cosmetic care that addresses society’s perception of hygiene and health, as with the burgeoning business in whitening teeth. Problems dealing with the jaw or any invasive oral procedure are usually undertaken by an oral surgeon, and dental hygienists and dental assistants do much of the routine dental cleanings, maintenance, and X-rays. Each state requires dentists to be licensed and hold a degree from an accredited dental school. In addition, dentists are required to complete a residency program and work in their area of specialty before becoming fully licensed. Individuals who are interested in oral care, promoting healthy living and enjoy working closely with patients will likely excel as a dentist.


Hygienists


Under a Dentist’s supervision, a Dental Hygienist provides preventative oral care to patients. This person is highly knowledgeable about oral health and has the highest level of technical and healthcare skills out of all three positions discussed today. A Dental Hygienist should stay up-to-date on up and coming dental technologies, have outstanding manual dexterity, and be passionate about helping patients achieve great oral health. This person must also be professional, detail-oriented, and friendly. Dental Hygienists usually work in one dental office or multiple offices of a single practice and don’t always work a full-time schedule.

Typical responsibilities of a Dental Hygienist include:


Dental Assistants


Dental Assistants are a crucial part of a dental office and work closely with both Dentists and Dental Hygienists. This position is primarily focused on preparatory responsibilities and assisting tasks. This position is perfect for someone who is hardworking, compassionate, highly organized, and who can listen and communicate effectively. Additionally, a Dental Assistant needs to have strong critical thinking skills and the ability to solve problems without getting flustered.

Common responsibilities of a Dental Assistant include:

Written by Revati Krishnan | Last published at: July 28, 2021


The five-digit code is common in both dental and medical coding. The first digit describes the field in which the service was performed (medical or dental). The second digit describes the category, and the remaining digits describe the nature of the procedure or service. For example, code D1110 is interpreted as follows: The first digit (letter D) indicates a dental service, the second digit (1) indicates a preventive procedure or service, and the last three digits identify the procedure or service.

The below are the 12 CDT Categories and their corresponding number series:

Diagnostic - D0100-D0999

Diagnostic codes apply to procedures common to patient examination and diagnosis and those which form the basis for treatment planning. These procedures typically fall into one of four diagnostic areas:


Preventive D1000-D1999

Codes in the preventive category refer to procedures conducted by the dental healthcare team designed to prevent the occurrence or recurrence of oral diseases:


Restorative D2000-D2999

Restorative codes apply to procedures concerned with the reconstruction of the hard tissues of a tooth or a group of teeth injured or destroyed by trauma or disease. These procedures are primarily classified by the restorative materials used in the reconstructive process. Common forms include the following:


Endodontics D3000-D3999

Codes for endodontics involve the diagnosis, prevention, and treatment of diseases of the dental pulp. Typical procedures performed by the dental healthcare team include the following:


Periodontics D4000-D4999

Periodontal considerations concern the care of the supporting structures of the teeth. Coding for periodontics is usually assigned to procedures such as the following:


Prosthodontics-Removable D5000-D5899

Codes pertaining to the restoration and maintenance of oral function, comfort, appearance, and health through replacement of missing teeth fall under prosthodontics. Procedures used in conjunction with removable prosthodontics include the following:


Maxillofacial Prosthetics D5900-D5999

Maxillofacial prosthetics codes apply to procedures used in the prosthetic restoration of facial structures that have been affected by disease, injury, surgery, or congenital defect. Some of these extensive procedures include the following:


Implant Services D6000-D6199

Oral implantation procedures performed by the dental healthcare team involve the surgical insertion of materials or devices into the patients jaw. Codes in this category can apply to either occlusal rehabilitation or cosmetic dentistry, such as the following:


Prosthodontics-Fixed D6200-D6999

Fixed prosthodontics coded concern procedures performed by the healthcare team that replace or restore teeth via artificial substitutes that are not readily removable. Typical procedures in this category include the following:


Oral and Maxillofacial Surgery D7000-D7999

Surgical procedures pertaining to facial extractions or closures are coded under oral and maxillofacial surgery. Classifications include the following:


Orthodontics D8000-D8999

Any procedures performed by the dental healthcare team concerned with the guidance and correction of growing and/or mature dentofacial structures are coded under orthodontics, including the following treatments:


Adjunctive General Services D9000-D9999

Any general procedures not classified in the previous categories are coded under adjunctive general services. Common procedures found in this category include the following:

Written by Renganathan K | Last published at: August 15, 2021


IDC Codes

International Statistical Classification of Diseases and Related Health Problems (ICD).

ICD purpose and uses

ICD is the foundation for the identification of health trends and statistics globally, and the international standard for reporting diseases and health conditions. It is the diagnostic classification standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries and other related health conditions, listed in a comprehensive, hierarchical fashion that allows for:

Taxonomy Code

A taxonomy code is a unique 10-character code that designates your classification and specialization. To find the taxonomy code that most closely describes your provider type, classification, or specialization, use the National Uniform Claim Committee (NUCC) code set list.

Reference: https://taxonomy.nucc.org/ 

 Modifiers

Modifiers are valuable coding tools that explain to payers the specific work that was done by a physician during treatment of a patient. They're important for representing the medical decision-making (MDM) a physician must demonstrate in order to bill, and be paid for, all the services they render.

What is a modifier user for? 

The Active Treatment (AT) modifier was developed to clearly define the difference between active treatment and maintenance treatment. Medicare pays only for active/corrective treatment to correct acute or chronic subluxation. Medicare does not pay for maintenance therapy.




Written by Sarah Abraham | Last published at: July 28, 2022


Overview

The production calendar is the functionality that helps a practice user set up their appointment calendar. The view that a user sees when opening their calendar is based on the instructions that you provide in the production calendar. We can set both provider availability templates as well as production templates.

Production Template

The production template is used by the practice to set all the production types that are preferred by a provider or practice in a particular operatory. To understand a production template we have to touch upon Production types and how they are used in a system.

Production Types

A production type is used by the practice to denote the kind of appointment or production that is being serviced. This usually helps practices to schedule appointments as certain providers would have a specialty associated. By depicting that production type in scheduler, the person scheduling an appointment for a particular appointment slot against a provider would know the preferred choice of appointment for them. For example, 'Hygiene production' would be a production type and the user can assign a Dental Hygienist to it. So when setting up the calendar, a practice user would set the operatory to show the production type 'Hygiene Production. Now when another user decides to take an appointment at that slot, the production type column would default to 'Hygiene Production'. 

A user can add a production type from Practice settings> Scheduler > Production type. 

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Here, we can add a production type to the system. The user can assign a time which is the average time it would take to service this production type. Up to 3 specialties can be assigned.

There are two types of Production types, Block as well as Non-Block production type which is controlled by the setting, 'Display as Block'. A block production type allows the user to set the provider availability against each specialty. Also, the duration plays a more important role as the duration of the appointment would be defaulted to the one set here regardless of the slot size chosen by the user. 

The user cannot delete a production type if it is used against an appointment but can only deactivate it. 

Setting up a production template

Users can navigate to Menu >Production calendar and choose the tab, Production template. 

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Hereupon choosing the particular location for which you want to set up a template, the user is shown all the operatories that are present in that particular location.

By default, every location will have a default template for each day. We can either edit the default template or add a new template. 

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Here we can see that a default template is present with multiple production types, set against operatories. The user can click the edit button on the top right corner and on clicking and dragging on slots, a modal is opened. 

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The user can choose the production type from the list of all active production types in the system and assign it a particular operatory.

The default template will always be set to a recurrence mode every week. That is the same template that will be shown for that particular week every day. It cannot be changed. 

If the user wishes to add a new template, they can do so by clicking on the Add button, a new modal is opened. Here the user is given the flexibility to change recurrence mode, start and end date.

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There are two types of templates, Day as well as Date. Here day template will be based on a recurrence mode for a particular day of the week. Date template will only reflect a particular date and has the highest priority.

The user also has the option to choose the same settings as that of an existing template. All the production types assigned would be brought over in this case. 

The recurrence mode is of two types, Weekly or Monthly. The weekly template allows the user to choose the interval at which the template must be applied to that particular day. For example, if the user chooses the model, 'Weekly' and the Interval in which it is applicable as 3, then the template would repeat itself every 3 weeks. 

If the user chooses the 'Monthly' mode, then they are given an option to choose from the first, second, third, fourth, and fifth particular day of the month. 

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Here I have chosen the monthly template and the first and third week. So this template would reflect on the first and third Monday of every month.

When a new template is added, the priority defaults to the last. To raise the priority, the user can drag and drop the template in the templates section to the top and priority would be rearranged based on the position of the template. 

A user can delete any template except for default templates.

Once the template is set up, if you navigate to the scheduler, all the changes made will be reflected according to the recurrence mode as shown below. 

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Now when we click and drag on the slots, with the template 'Hygiene Production', the appointment booking modal has the field Production type defaulted to it. The user is only prompted here and can change at any time. 

The provider tab in the production calendar is used to assign providers to each operatory/chair so that the front office users know which provider will be working on each operatory that day and book appointments looking at their schedule for the day. Here also we have a day template and a date template for providers. Date templates are of the highest priority.


In the provider tab, the drop-down will list all the active Dentist and Hygienist providers that are in the practice.



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  1. Add plan button will open the Add day template modal.
  2. Template type - Choose between day or date template
  3. Template name 
  4. Day of week 
  5. Recurrence mode
  6. The start date signifies the date on which the template becomes active. 
  7. End date signifies the date on which the template becomes inactive. 
  8. Add location lets you add multiple locations
  9. Location will list down the accessible locations for the selected provider.
  10. Operatories will list down the operatories available for the selected location. 
  11. Start time and end time are assigned based on the provider’s availability in the chair on that day.
  12. Delete under the actions will delete the row added
  13. Save will save the changes made to the template


Once a template is created, it gets listed at the bottom. The hierarchy of the template is based on the order in which it is set. Users can drag and drop the template to change the hierarchy. Based on the hierarchy, changes will be reflected in the Scheduler.


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Edit icon under the Actions will let you edit the template. Delete will delete the template for the chosen provider.

Scheduler view will show the Provider’s availability panel based on the templates assigned.



Touchpoints & Impacts



Written by Sarah Abraham | Last published at: August 08, 2021



Overview


Appointment calendar or Scheduler is used by the practices to view the day-to-day schedule for every provider for chairs across locations. The scheduler is used to book appointments, block slots, reschedule, change status of appointments etc. 


Topics Covered in this Article

In this document we will cover the following areas related to scheduling.

Appointment Calendar and Functionalities

The scheduler can be accessed from multiple areas in the PMS. 

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Based on the production calendar setting configured for the location, the operatories will be displayed. To know ore on how the calendar is shown, please check the article on Production calendar.


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Booking an Appointment

To book an appointment, left click & drag on the available scheduler slot.An appointment details slide-out will appear. 




Appointment Right Click Menu

Right clicking on the appointment block will open the Appointment right-click menu which will show the following details :-     

Blocking a Slot

To block a slot on the calendar, click and drag the slot and choose Block. Start time , End time, Block color and the message to be shown on the Block can be entered


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Written by Ashly Abraham | Last published at: August 16, 2021


Overview
Dental laboratories manufacture or customize a variety of products to assist in the provision of oral health care by a licensed dentist. These products include crowns, bridges, dentures, and other dental products. Dental labs fill prescriptions (Lab Cases) that a dentist submits to fabricate whatever appliance, restoration, or prosthesis the dentist requests in writing.

There are several different types of dental labs:

Topics Covered in this Article

Permissions required


How to add a Lab in Carestack?

How to add Lab case to an Appointment?

You can add lab cases to your appointment directly from the scheduler.

  1. Click the Edit link next to the Lab Summary.  

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  2. Details regarding the Lab case can be entered. 
  3. Click Save or Save & Print.
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How to add a Lab case from the Patient Context?

What a Lab Case Looks Like

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Who uses this Functionality

 Front office admin, providers, hygienists etc use this functionality.

Permission Associated

Lab Case View - Permission to only view the Lab Cases.

Lab Case Edit - Permission to Edit the Lab cases.









 


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Written by Sarah Abraham | Last published at: August 08, 2021


Overview

The scheduler print is a functionality that we provide that enables the practice to take a print of their schedule. They can do this for each location, operatory as well as provider. We also allow the practice to use these functionality to take a print in their preferred view, ie, Patient, Eligibility, HIPAA as well as the custom view that we provide.

Scheduler Print and its Functionalities

The  print button is available in the top right corner of the Scheduler. 

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On clicking on this button, the print modal is opened which is shown below.

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Let us go through each of the options presented here.

Sample Print

Scheduler_Print .pdf

Permissions Required

Any user who has permission to view scheduler is allowed to take print of scheduler.

Written by Sarah Abraham | Last published at: August 08, 2021


Overview

The routing slip is a document that contains pertinent patient information such as their health history, outstanding payments, appointment related information,insurance information etc. This document is usually printed for all the patients who have appointments on a particular day. The routing slip is handed over to the patient at the beginning of their visit and usually has information that is required by each and every department during their clinic visit.

Printing a Routing Slip

The routing slip print can be taken from multiple areas in scheduler. If the user wishes to take the print for all the patients that have appointments in a particular location, they can do so by clicking on the Print icon on the scheduler top bar. Here the option for routing slip is available. The user can choose a date, location and time period and take the print.

Related image: ./carestack-questions-2023-03-02_files/1628419485731-1628419485731.pngYou can also print routing slip for a patient, by opening the appointment details page and choosing Routing slip by code or Routing slip by treatment plan.

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Routing Slip by Treatment Plan

In this routing slip, all the codes added to the patient will be dispayed in the Treatment plan sections. The treatments are grouped according to their appointments and the unscheduled codes are shown separately.

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Routing Slip by Code

Here instead of a treatment plan details, we have 'Productions' sections. The codes that are added to provider in User settings are listed here. This is done cause some practices prefer to see these codes that are mapped against a specific provider.

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The first section of the routing slip is patient related information like name, Date of birth, address, responsibility party details etc. This also includes medical information like allergies and conditions of the patient. We also provide information related to appointments, like the last appointment date, the number of missed appointments etc. All details of current appointment is also listed. 

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Insurance Details

In this section all the insurances, both dental and medical as well as their status is listed. The user is also given information like the subscriber name and ID, carrier and employer name as well as Individual and remaining maximum along with the deductible.

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Account Details

Here all the active account members of the patient are listed as well as their appointment details. The individual balances and unapplied credits against each account member is also shown.

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All the recall related information of each account member is provided. Details like recall due date and their status is also depicted.In case the recalls are scheduled, the date of appointment is also shown.

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Written by Sarah Abraham | Last published at: August 22, 2021


Overview

The find slot logic is a functionality that allows the user to find the next available free slot that fits the selected criteria.

Find Slot Logic

The user can open the Find slot modal from the Find slot icon on the left panel in scheduler.

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The user can also open the find slot modal from the Search filters in the top panel.
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The user is provided the option to customize their search and is given four criteria to choose from. 
The first is the location filter. All the locations the user has access to is shown here and the user is allowed to choose upto 10 locations at the same time.
The second filter is Speciality. Here all the specialities in system are listed and the user can choose any or All of them. The third is the provider filter which lists all the providers in the location and the last one is the production type filter. Here also the user can choose All or Any. 
The criteria selected by the user is shown on the right side of the modal. The user can also eliminate choices from here as well.
When a user chooses specific providers and speciality, only the providers who belong to that functionality will be considered for the search.

The search first checks for the location and if the chosen providers have provider availability set for any of the operatories in that particular location. If that criteria is satisfied, then all the available slots that aren't booked or blocked is filtered. The maximum concurrent availability also comes into play and it is ensured that the maximum value is not exceeded.

When a production type is chosen, only the operatories that have any of the production types chosen, assigned to them are considered. Here the specialities that are assigned to the production types also comes into play. Irrespective of the provider or speciality chosen in filters, if the speciality chosen does not match that of the production type, no results are shown.

Eg: If a production type is added with speciality dentist and hygienist, then we need to add providers of types both dentist and hygienist to the chosen location. If both these providers are assigned to an operatory and slot is free, results are shown.

 Holidays are avoided and the working hours of providers are also considered to give a complete experience to the user. 


Written by Sarah Abraham | Last published at: June 01, 2022


Overview

When a patient calls in to book dental appointments, they very often ask for multiple appointment slots so that everyone in their family can complete all their dental checkups at once. This would involve booking slots at the same time with different providers or booking appointments one after the other with the same or different dentists.

They also use this functionality daily to search for exam appointments followed by hygiene visits for the same day in back-to-back time-slots. This is also very relevant for Pediatric practices as parents prefer to bring their children to visit the dentist together. 

Booking a Family Appointment

The current find slot functionality would be extended to search for more than a single slot. Whenever a user opens the Find slot, it would be defaulted to search for a single appointment. Users can change this and choose to search for a maximum of 4 slots at a time. We can also choose whether to book concurrent or consecutive slots. We have set a maximum of 4 keeping in mind family cancellations could be costly to the clients. Consecutive Search looks for time slots one after the other and the concurrent Search for the same time slot across operatories. 

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 Currently we can search for multiple providers and production types but in the case of family appointments we would require the ability to define which type of provider or speciality is required for each appointment. For eg: Choose speciality 'Dentist' for the first slot followed by a 'Hygienist' slot. The same would be applicable for speciality as well.

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The user would book the slot one after the other from the Find Slot slideout without having to navigate to scheduler as the opening the flow could mean that the second slot never gets booked if they got out of context. Once all the slots are booked user should be navigated to the scheduler with the appointments booked highlighted.


 

Written by Sarah Abraham | Last published at: June 01, 2022



Overview


The Appointment tile shown in scheduler and print of the schedule is one of the most information heavy areas in Carestack. Each practice works in different ways and the data they want to see on the tile in one glance is very varied. We have hence brought customisation to this view to help practices set up the tiles in the way that is most convenient anf effective for them. 

Scheduler Views 


There are five views that are provided for the Scheduler in Carestack. They are


Configuring your customised Appointment tile 

The pratice can choose to customise the Appointment tile from Practice Settings under Scheduler > Scheduler Settings> Customization of Scheduler Views.  


Patient View


Appointment Block Settings

The users have the following options to choose from 

Data Options

The following options are present 


HIPAA View


Appointment Block Settings

The users have the following options to choose from 

Data Options

The following options are present 


Eligibility View


Appointment Block Settings

The users have the following options to choose from 

Data Options

The following options are present 


Claim View


Appointment Block Settings

The users have the following options to choose from 

Data Options

The following options are present 


Custom View

Appointment Block Settings

The users have the following options to choose from 

Data Options

The following options are present 

Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


Your Basic Account Information is used to populate these details in claims, forms, letters, and other correspondence. This practice-level information can flow to the individual locations. You will also add location-specific information to override this account-level information. 

Update the details of your practice by following these steps below:

1. From your system menu, select Practice Settings.

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2. When the screen loads, you'll see the Basic Information page listing your account details. This is where you will update your practice information on the "account-level".

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3. Click Edit in one of the corresponding sections to update the listed information:

Account Details

Note: This is the information that will be automatically populated
if you choose "Global Branding" for your marketing campaigns.
 


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Social Links

In this section at the top-right of the page, enter the URL of your social links if you would like to include them in your marketing campaigns at any point. 

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Practice Logo

Upload a logo for your account at the practice-level. This is useful when you are using global branding for your forms and letters.


4. Remember to hit Save when you are done. 

You will receive a green confirmation message:
"
Account details updated successfully." 

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Written by Geo Thomas | Last published at: August 19, 2021


Location Level Settings


Locations are the individual offices where you serve your patients and/or process payments. For  statements, patient engagement campaigns, letters, and forms, you may choose to show  location versus account details. When you choose location-based settings, they come from  these location settings. Locations are added to CareStack from the back end and so a service request is to be created if a practice requests to add a new location. Once the location has been added, it would be visible in System Menu > Practice Settings > Locations

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Each of these location would have a Short Name and Name displayed here, clicking on any location would show more details, options and settings regarding that location under different tabs.

Details

Here, the basic contact information regarding this location are to be added.

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If this location works only for certain days of the week, it is possible to skip the unwanted days in the scheduler by setting it up here.

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If location level Patient Portal is set to Enable, the link to this would appear here.

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Billing Details

If the practice uses a location level billing, it can be set up here.

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If Use Account Settings is set as No, CareStack would give the option select a Billing Dentist or a Dental Entity, where more details regarding the chosen option are to be entered.

If it is set as Yes, the details would get auto-populated.

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Working Hours

If it is set to use account settings here, the details would get auto-populated form the account settings.

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If the location level settings is enabled and a day has been set as a working day, all the other fields would become editable.

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Holidays

Holidays are the days that the location will be closed and will not accept appointments. Setting these holidays will automatically grey out the scheduler for the day. It would still be possible to book appointments for the day.

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If location level settings is enabled, the user would be able to add/delete locations level holidays.

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Operatory Settings

There are no account settings for operatories. Operatories are added/deleted at the location level.

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Operatories are arranged in the schedule alphabetically regardless of the  order in which they were added. Many practices will add “Op1” or “OpA” as a  preface to a provider’s name. Operatories can also be deleted from here, but the ones with already booked appointment slots cannot be deleted. 

Print Settings

It is possible to set up what to appear while printing, at location level. This is possible in case of treatment plans and unscheduled recalls.

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Online Appointment Settings

It is here that the online booking feature can be enabled for the location. It is possible to set it to account level or location level settings. This would enable the practice to set the production types that should appear while booking online appointments, at a location level if required.

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Logo

If the location has its own logo, it can be added here.

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 If the location uses the account logo, the account level logo found in the  Basic Information section will apply. 

Social Links

Social Media links like Facebook, Twitter, Google+, and Yelp can help increase the location’s visibility. The links can be included in patient engagement campaign and in letters and documents for added communication.  

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If the location has its own social media presence, location’s respective links can be added here. If the location uses the account’s links, the account level social links found in  the Basic Information section will apply.

Location/account level branding can be selected while creating a campaign.

Required Permissions


Users would require separate permissions to view/edit locations

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Written by Rahul Krishnan | Last published at: August 15, 2021


The items that a user can view or complete in the system are defined by their assigned Profile Type that is selected during the user setup. For example, a user could be tagged as an Insurance Verifier, Dental Assistant, Front Desk Receptionist, Treatment Coordinator, or just about any role type you can think up. Each of these roles would have a unique combination of permissions enabled, allowing them to complete their daily workflows throughout the system, while also restricting them from the things they do not necessarily need access to.


Create a new Profile Type

From your practice settings, select  Administration > Profiles  on the left side menu.


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2.In the pop-up window:

3.When you are finished, hit  Save   (if you are editing an existing profile type), or hit  Save & Continue  (if creating a new one) to begin working on the permissions settings.

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Assigning Profile Type Permissions

After clicking   Save & Continue  (or if you clicked  Manage Permissions  next to an existing profile type to update its permission settings -- pictured in the previous section)  the following screen will appear:


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You can also click on the I button next to each permission line item so that you can view the actions that can be done by granting the permission.



Written by Geo Thomas | Last published at: August 19, 2021


Permissions in CareStack enables the practice to decide what a user should see in CareStack. Since there would be multiple users and each user has their own specific duties, it would be better to grant them access to the specific sections of CareStack as they are dealing with patient's health information. 

Different profiles can be created using any set of combinations of permissions. The Super Admin profile is the only profile that is system generated. This profile has all the permissions. 

Profiles


Profiles are used to set permissions. Since there would be multiple users with the same job role, a profile is to be created such that the permissions of the profile fall in line with the job role of the user. This can be done in System Menu > Practice Settings > Administration > Profiles 

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Upon clicking Add, a pop-up would appear, where the name of the profile, its description and the logout time has to be entered. Once this is done, click Save & Continue.

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This would open the permissions page. 

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Here, by default all the permissions would be set to No. After giving the required permissions, click Save and thus the new profile would be created.

Permissions


Each set of permissions give the users the following abilities.

Billing

Adjustments

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BluePay Transaction

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ClearGage Integration

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Collection Agency Payments

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ERA

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Edit Fees

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General Payment Plans

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Insurance Payments

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Migrated Starting Balance Codes

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Orthodontic Payment Plans

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Patient Payments

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Statements

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Claims

Authorizations

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Claims

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General

Alerts

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Audit Trail

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Close Out

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Documents

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Practice Providers

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Referral  Providers

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Time Clock

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Patient

Communication

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General and Patient Information

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Insurance Info

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Ledger

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Medical Alerts

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Medical History Forms

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Memo

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OrthoFx

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Prescription

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Transaction Log

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Practice Settings

Administration

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Automatic Patient Inactivation Configuration Settings

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Basic Info

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Brands

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Care Audit Rules

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Carriers

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Clinical Settings

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Codes

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Collection Agency

Document Types

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Drugs Settings

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Employers

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Fee Table

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Insurance Categories

Related image: ./carestack-questions-2023-03-02_files/1628864924839-1628864924839.pngLab Settings

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Location

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Medical Alerts Settings

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Medical History Forms Settings

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Office Assistant Settings

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Office Wizard Settings

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Patient Flags Settings

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Patient Portal

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Payments Settings

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Plans

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Referral Sources

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Report Settings

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Scheduler

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Services Settings

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Template Settings

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Patient Engagement

Campaigns

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Communication

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Email Templates

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Image Gallery

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Postcard

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Reputation Management

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Reviews

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Text Templates

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Voice Templates

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Reports

Reports

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Widgets

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Treatment

Treatment

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Scheduling

Lab Cases

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Production Calendar

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Scheduler

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Insights

Advanced Analytics

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Analytics Dashboard

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General Settings

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Goal Setting

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Operational Reports

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Patient Segmentation

Patient Segmentation

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Written by Mathew Kandirickal | Last published at: August 15, 2021


To access and use CareStack, a person needs a user account which will be associated with one or more locations and one or more profiles. Once the user is created with a unique username and email address, the practice will be able to designate him or her as a provider and add other permissions.

Adding a New User


To create a new user or provider in CareStack,  we can follow these steps below:

    - Select Practice Settings from the system menu.

    - When the page loads, select  Administration > Users on the left side panel, then hit Add at the top-right (pictured below).

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     - In the pop-up window, enter the new user's details. The items marked with a red asterisk (*) are the only fields that are mandatory:

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   - Hit Save & Continue when finished Or click Save to come back to this later -- at this point the user will not yet have login access.

    To continue entering the user's information, click on one of the tabs on the left side of the window, then click Edit to enter the relevant details (discussed further in the sections listed below).


Provider Details

    - Click the tab for Provider Details, then hit Edit to begin making your changes.

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Login Details

Click the tab for Login Details, then hit Edit to make changes.

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Working Hours

     - Entering working hours enables the practice to limit the hours of the day that the user can access the system.

     - Click the tab for Working Hours, then hit Edit to make the changes.

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   - Checkmark the option to Enable Working Hours if desired.


Deactivate a User or Provider


In order to deactivate a user or provider, follow these steps below :

   - From the system menu, select Practice Settings.

   - When the page loads, select Administration > Users on the left side menu, then search for the intended User or Provider who needs to be disabled.

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    - Once the user or provider is located, select Deactivate User in the far right column. 

    - In the pop-up window, the practice needs to confirm whether the correct User or Provider is selected. Choose whether this individual should be deactivated Indefinitely or for only a selected Time Period, then enter the Start/End Date.


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By Deactivating the Selected User, the following changes will take place :


Written by Rinu Seba Joemon | Last published at: August 15, 2021


Office Regions and Divisions


CareStack gives you the ability to group your office locations by Region and Division. To utilize this feature, the user will have to reach out to a CareStack Representative, and the feature would be enabled for the practice.

Once this feature is enabled you can follow the below-given steps to create your respective Regions and Divisions (as long as your user permissions are enabled for such). then use these in generating your business reports.

To check for permissions you may navigate to the System Menu > Practice Settings > Administration > Profiles > Click on Manage Permissions at the right end of the profile type > Practice Settings.


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 Create Your Practice Regions 

  1. You can start by navigating to your System Menu > Practice Settings > Administration > Region > then hit  Add at the top-right. 

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  1. In the pop-up window, enter a name for the region you are adding, then select the Locations that should belong to this region.

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  1. Hit  Save when you are done. 

You will receive a green notification message:  " Successfully added Region ."


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Create your Practice Division 

  1. On the left side menu of your practice settings, select  Administration > Division,  then hit Add at the top-right.

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  1. In the pop-up window, enter a name for the division you are adding, then select the regions that should belong to this division.

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  1. Hit  Save when you are done.

You will receive a green notification message:  " Successfully added Division ".

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Written by Athul V Suresh | Last published at: August 15, 2021


Insurance companies/carriers group the ADA codes into different Insurance categories and determine coverages for each category. The coverage determined by the insurance carriers will be the percentage of the total fees the carrier will pay. Even though most categories like preventive, Diagnostics, endodontics is common, each carrier defines its own insurance categories and the codes that come under each category. Simply put not all categories and are common and codes under each category are not uniform.

So how do you resolve this issue a practice might have multiple numbers of carriers they are associated with and all these carriers might define categories and coverages differently. CareStack has you covered here. you can add multiple coverage groups and subcategories for each category.

Insurance Categories Groups

To add insurance categories navigate to System menu > Practice settings > Insurance categories > Manage new insurance groups > Add

To delete insurance categories navigate to System menu > Practice settings > Insurance categories > Manage new insurance groups > trash icon.

You can use the edit button to edit the name of the insurance category group.


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To set an insurance category group as default you can click on the 'set as default' check box

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Subcategories

Once you add a new insurance category group you would need to add subcategories and add codes to those categories. You can specify the name and coverage of the category and add codes from the list codes in your practice. Codes ones added in subcategory cannot be added to another subcategory in the same insurance category group.

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Edit/Delete Subcategories 

To edit subcategories you can click on the pen icon next to the subcategory and make the necessary changes as you wish. To delete the subcategory you can click on the trash can icon to delete the category.

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Viewing codes under each Category 

To view codes under each subcategory you can just click on the subcategory.

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Linking Insurance Category groups to Plans

To link the insurance groups to plans you can either navigate to system menu > Practice settings > plans > select the plan > Coverage.

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Here you can select the insurance category group and even edit the coverage values for each sub-category. The values you enter here for percentage coverage won't change the values assigned for the subcategory under practice settings. 

Or you can navigate to the patient's Insurance tab > select the plans > coverage > edit. Here you can give custom coverage values for each subcategory which will only affect the coverage values for the particular patient.

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Written by Abhishek Vijay | Last published at: August 15, 2021


You’ve seen a field of “Employer” while entering in the insurance for a patient, and are wondering what that means. Well, you’ve come to the right place!

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An employer-employee insurance policy is one in which the firm or employer acquires an insurance policy with its employees as the beneficiaries. It's a perk that a company offers to new workers as part of the onboarding process.


Associating an insurance plan with the company that provides it facilitates the process of adding the relevant plan to the patient's account.”


Instead of adding an employer detail every time we create an insurance account for a patient, we can create commonly used employer details as per the practice demand.

To set the same, we head to our beloved central setting page, Practice Settings.


System Menu > Practice Settings > Employers

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Once we’re on this screen, we are presented with the option to Export the existing list, Add a new entry inside this list, or merge similar carriers together. Let’s check the options one by one.


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Once you click on save, the entry added will now be available inside the insurance plan screen to be entered as an employer for that patient’s insurance.


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We can now go ahead and click on the field to bring up further options for the Employer.

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Here, we can add the contact details of the employer, as per the information we have received from the patient’s insurance details.

Once this is updated, the entries would show up under the Sales Representative, Email and Website columns of this page, which can be changed at any time.


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The Destination Employer is the entry you want in the list and the Employers to be merged are the duplicated one’s you want to get rid of in the list. Too confusing? Allow me to rephrase!

Destination Employer: The actual entry, you need this one to be in the list after the merge.

Employers to be Merged: The duplicated/mistaken entries made which we want to get rid of.

As the warning shows, once the Employers have been merged, it’s hasta la vista! The merged entries cannot be unmerged (is that even a word?)

Since we’re all human, we would have situations where we would still want to see the merged employers in the list right? Well we got that covered too!

You can simply click on the checkbox at the top “Include Merged Employers” and lo and behold! All the entries are back, but the merged entries will have the tag “merged” along with them.


Like every other entry inside the Practice Settings page, the Employer entries also require permissions for a user to have access to all the specified actions.


System Menu > Practice Settings > Administrations > Profiles > Manage Permissions > Practice Settings > Employers

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Once the user has all these permissions, they can perform all the above stated changes.


The changes made here also reflect on the Audit Trail, and has been demonstrated below.

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Well there you go! Try it out for yourself and embrace the mastery of adding an employer!

Written by Aswathy B Nair | Last published at: August 10, 2021


An insurance plan contract describes the details and requirements of the coverage being provided to the patient by the insurance carrier. An insurance plan can be either added from the Practice settings or from the patient’s Insurance page while adding new insurance.


How to Add an Insurance Plan



You can add an insurance plan by going to System Menu > Practice settings > Plans > Add

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On clicking “Add”, an “Add Plan” window opens where we enter the Carrier and Plan details.


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Carrier Details


If you want to add a carrier from existing: 


 

 

If you want to add a new carrier:


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        This opens new mandatory fields.

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Plan Details: 

 

You can click on Save or Verify and Continue

If you click on Save, all the details that you have entered will be saved. A green toaster will be shown on the top right and the plan will be in the Pending Verification Status.

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Now to verify the pending plan, you’d have to click on the plan > Edit > Verify and continue. Once you do that, it takes you to the Benefits tab. The same happens if you click Verify and continue in the first place without clicking on Save.

Now let's take a look into the various tabs.


Benefits


You can enter the benefit details of the plan. Enter the family and individual maximums and deductibles as defined by the insurance plan, then enter the eligibility rules that define the plan's exclusions and limitations.


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Hm.. not able to enter them? Scroll down and click on Edit. There you go!!!

Hit on Save when you have entered all the details.


Coverage


CareStack uses Insurance Categories to define which procedure codes should be included in each dental category (in order to specify the coverage defined in the insurance plan). Select an insurance category group (or use the default), then enter the coverage percentage per dental category.  In the bottom section, you can enter a coverage percentage for any specified procedure codes. 

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You can enter two different coverage tables for insurance plans, then assign the relevant treatment providers to the relevant coverage table for proper treatment fee calculations. This can be set under Practice settings > Fee tables > Settings. Click on edit and if you set Associate two coverage tables to Insurance Plans to ‘Yes’, then you would be able to see two tables. 


The values in coverage table 1 would be used for calculating fees for providers not assigned to the coverage table.


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Pre Authorization Codes

Click on Edit and then you can set the Categories and codes that should automatically draft an Authorization claim once the treatment has been accepted by the patientClick on Save and the codes will be displayed there. 


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You can delete a code from this list too! Click on the trash icon corresponding to the code and you’d be able to delete the codes from automatically drafting a pre-auth.


Fee Schedule Assignments

Copy the fee schedule assignments of another plan that is in the system, or choose your own fee schedule assignments (select the fee schedule, then choose whether to limit this assignment to a location/provider/specialty).


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Alternate Benefits Codes

Select any procedure codes that will be subject to an alternate benefit (such as in the instance that the insurance will cover a silver crown rather than a gold crown).


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You might have seen some buttons on top right of the landing page for plans right? 


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Curious to know what they are? Let’s see what each one of them is for.

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Enter the details and click on Merge which will merge the plans.


To see the inactive carrier types, click on the check box “Show Inactive Carrier Types”.

You can edit the details of the Carrier types by clicking on Edit and can Deactivate them by clicking on Deactivate. Also, you would be able to Activate the carrier types which were deactivated by clicking on Activate.

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Plan Types


Before we discuss the plan types, let's discuss what in-network providers and out of network providers are.

 

Networks are created by Insurance companies. Insurance companies ask providers if they will charge agreed-upon rates for specific services. If the providers agree to these rates, they can be called an “in-network provider.” If the providers do not agree to join the network, the health insurance company will label them “out-of-network.”

 

Now we can get into the Plan Types.

 


A table that compares various plan types


Plan Type

Deductible

Premium

Referrals

Out of network Cov.

HMO

Low

Low

Required

No

PPO 

Low

Low

Not Required

Yes

Indemnity

High

High

Not required

Yes

Copay



Required


Medicaid/ Medicare

Low

Low

Not Required

Yes

Discount

No No Not Required Yes



Written by Mathew Kandirickal | Last published at: August 15, 2021


Support & Assistance


The users will have many queries regarding CareStack. Getting help with them becomes an easier task with the Support & Assistance in CareStack.

The user can navigate to Practice Settings > Support & Assistance.

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CareStack University

If the users are getting started with CareStack or taking a new role, they can learn the complete workflow and tasks through videos, instructions, and interactive elements.


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User Resource Center


URC is a self-help resource for task specific "How to" and "Problem Solution" articles. If they forgot what to click to add an insurance payment or if they want to get started with online scheduling, this is the best place to go for the user.


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Live Support


In case the user want any answers or help regarding any issues from a live support agent, they can opt for Live Support option.


The user can also open up the new support chat by clicking on the Support button from the Menu. Then the user would have to fill in some required details after which they will be connected to a support agent.



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Screen Guidance

Sometimes the support agent may have to access and see the screen of the user in order to provide more efficient assistance. The Screen Guidance will help in this regard.

The user would have to :



Written by Renganathan K | Last published at: August 15, 2021


Audit trail is used to check the user's trail of activity to troubleshoot and assess workflow errors.


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Select the  Sync  button at the top-right to refresh the module and sync it with the more recent actions that have been completed in the system since the last time this button was pressed.

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Use the column headers to filter for the desired user / patient / action / etc. that you are looking for.


Written by Rahul Krishnan | Last published at: August 15, 2021


Flags act as identifiers which help us in identifying specific type of patients that are defined by the flag. There may be a number of reasons to flag a patient's account:  to label them as an employee at your practice, or a patient speaking a native language other English, or perhaps to flag their account as Sent to Collections... Luckily, your practice has the ability to craft as many custom flags as you can think up to suit any variety of needs. In addition to the custom flags, CareStack also has the following System labels/flags which are included by default- 

1.Mark as Inactive- Used to flag inactive patients in a practice

2.Mark as Duplicate-When duplicate accounts exist for a patient, the second account can be marked as duplicate by using this system label. You also have the option to merge this duplicate account into the original account.

3.Bankrupt-Used to denote that the patient is broke and can no longer pay for any charges or the already existing balances. It helps the practice to avoid performing any new procedures for this patient until the existing dues are cleared.


4.Assign Benefits to patients-When benefits are assigned to the patient, it means that the patient will be responsible for paying their treatment fees, and any insurance benefits will be reimbursed back to the patient.


5.Sent To Collections-Sometimes patients just don’t pay their bills. The Practice tried. They prepared the treatment plan with the estimates and accepted payments when they could. They sent letter after letter. Maybe they even made a payment plan arrangement, but the patient still can’t or won’t pay. When the practice is ready to quit and pass the work over to a professional Collection agency


6.Do not Send Statements- If this flag is added to a patient, this patient will be skipped whenever generating batches of patient statements.

The patient flag is visible wherever there is a patient summary (on the patient's search result in the global search bar, on the appointment summary in the Scheduler, and on the patient's profile). Patient Flags are useful for excluding certain accounts with that label from receiving a patient engagement campaign or when generating a statement; you can also use it as a filter when running your reports/ generating patient lists.


In addition to the system flags mentioned above, a practice can create as many custom flags as they wish. One can view the custom patient flags that have been set for your practice by navigating to System Menu > Practice Settings > Patient flags > General.


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To add a new patient flag, you can click on Add at the top-right of the screen to create a new patient flag.

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Enter the following information:

1.Short Description: Enter a short name that will appear whenever the patient is tagged with this flag. It can be up to 3 letters (for example: CH = Child).

2.Description:  Enter a description that easily identifies the purpose of this flag.

3.Set as Account Flag:  Select Yes if the flag should be tagged to all members of the account when selected. 

4. Choose a Color:  Select a color that will represent this flag.

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Click Save when you are finished. You will see a green confirmation message at the top-right of the screen.

You can edit the information of an existing Patient Flag type by clicking on it and selecting Edit. However the account flag setting of a patient flag cannot be changed once it has been defined.


Flag a Patient or Account


To tag a Patient Flag to a particular individual, follow these steps below:

1.Open the patient's profile by searching for them in the global search bar.

2.On the patient's overview page, you'll click on the  Edit Labels  hyperlink at the very top-right.

3.In the drop-down window, select the flag(s) you would like to tag to this patient.

Please Note:  Patient Flags listed in the Account Labels section will be tagged to all family members in this patient's account.

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If any label has been attached to the patient, it will be shown in the Patient's overview page and this will update to the patient's demographics.

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The flag can be removed by simply unticking the label.


Permissions Required

A user needs to have the necessary permissions to view patient flags as well as to Add/Edit Patient flags set to 'Yes'  so as to perform the above mentioned actions.

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Written by Rinu Seba Joemon | Last published at: August 15, 2021


Time Clock


Clocking In & Clocking Out of CareStack

  1. Open your system menu by clicking the icon on the far-right of the CareStack toolbar.
  2. Select Clock In (or Out) from the drop-down menu.


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NOTE:  Clocking Out will cause the system to automatically sign you out of CareStack as well.


Automatically Clock in Upon Login

Enable automatic clock-in on a per-user basis from your Practice Settings:  

      • System Menu > Practice Settings > Administration > Users > select the intended user > Login Details > Edit > Set Auto clock in on Login as 'Yes' > Click on Save.

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Edit Time Clock Entry

Note: Your ability to edit time clock entries will be dependent upon your profile type permissions.

To check permissions navigate to the System Menu > Practice Settings > Administration > Profiles > Click on Manage Permissions next to the user profile > General > Time Clock.

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To update a user's time clock entry, open your System Menu > Operations > Time Clock 


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  1. At the top-left of the screen, choose the tab titled Time Clock Entries for all Users.

  2. Select the user's name from the left-side menu to view their time entries.

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  1. Click the  Edit hyperlink to the far right of the item you would like to update.

  2. Make your changes, then hit Save.


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 Note: The red font indicates that the time entry has been altered.

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Forgot to clock in today?

If the user forgot to clock in today, select  Click here to clock in the user on the far right.

      • The following window will appear:

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  • Enter your notes, then hit Ok.
  • If needed, edit the time entry to state the correct clock-in time.


Forgot to Clock in on Another Day?

If the user forgot to clock in on a past date, select  Add time clock for a specific date.

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    • The following window will appear:

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  • Select the date for this time entry.
  • Select the clock-in/out times.
  • Enter your notes, then hit Save.


Clock In Clock Out Report

For a report of each user's time clock data and time-based pay detailscheck out the  Clock In- Clock Out Report.
Kindly navigate to the System Menu > Insights> Operational ReportsClock In - Out Report.

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Kindly take a look into the workflow and practice!

Written by Rinu Seba Joemon | Last published at: August 22, 2021


Services include the third-party software that the practices have enabled such as DoseSpot, NEA FastAttach, CareStack Imaging, Apteryx XV Web, etc. 

Permissions:

To access the permission page the user would have to have certain permissions. The required permissions can be set by navigating to the System Menu > Practice Settings > Administration > Profiles > Click on manage permissions next to the user profile > Practice Settings > Service Settings > Set 'yes' to enable to permissions > Click on Save.


Related image: ./carestack-questions-2023-03-02_files/1629151378594-1629151378594.pngYou may navigate to the System Menu > Practice Settings > Services to view a specific practice's software.

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The services page shows the Service Name, Description, Options.

Service Name: The name of the service the practice has enabled.

Description: A short explanation regarding the service.

Options: This includes the Configure icon and the Website hyperlink that takes you to the service website.

Written by Revati Krishnan | Last published at: August 15, 2021


So, you’ve added a treatment and completed the services, what’s next? The most important part for the practice and in fact all of us, getting paid!

“Payment types describe how you might receive a payment.”

CareStack has the facilities to accommodate a variety of payment options, which will then be available for patients to provide the payment for services completed. Making sure that the practice accommodates numerous payment methods is a sure fire way of ensuring more business. It could range from a simple cash transaction to a variety of Credit/Debit Cards or even custom types as suited for the practice.

The payment types available for a practice can be seen at every inlet of adding a payment, be it adding a patient payment, adding an advance payment, adding an insurance payment and so on.

A major point to be noted here is that once a payment type is 
created and used, it cannot be deleted, though it can be deactivated. So make sure that the client and yourself are in complete agreement before initiating a request for the same.


In case any of these settings are unavailable for you or any client, make sure that you check the permission of the user’s profile. Tell you what, check that at the beginning of the process to ensure that we are not fiddling in the dark! The permission are available at:


System Menu > Practice Settings > Administration > Profiles > Manage Permissions > Practice Settings > Payments Settings

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Similar to any process of making practice wide changes, we move on to Practice Settings to add a new payment type. The path for the same is as follows:

                                   System Menu > Practice Settings > Payments > General > Payment Type > Add New Payment

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Now that the payment type has been created, you can check the points of impact and then make sure that everything is reflecting as per the requirement. 

In order to edit an already existing payment type, you can simply click on Edit towards the bottom right of the entry you require, and then make the necessary changes.

Payment Types can be edited only if it has NOT been set as default payment type for anything. It is recommended that the practice user performs such actions with us guiding the workflow alone.

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If the requirement is to delete a payment type, it can only be done if the payment type is not set as the default payment type for anything. If so, you may just click on the dustbin icon for the same.

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Once all the required changes have been made, you can click on save at the bottom, and voila! You will be greeted with a green toaster at the top right stating “Payment Type updated successfully

Now let's have a look at all the regions where payment types are present and available for use!

Adding a patient payment

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Adding an Advance Payment

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Adding a Payment Plan

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Adding an insurance payment receipt

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So wait, does this mean you can make any change you require inside the payment type settings? Wrong!

All the changes you make inside the Practice Settings are logged inside the Audit Trail under Setup as shown below.

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This is a great method to find out about which user made the changes, just so the practice can keep track. The practice can also find out if you make changes and mess up, so always be careful while making changes!


You’re the master of it all now! Go ahead and try it out for yourself. Practice makes perfect!

Written by Revati Krishnan | Last published at: August 23, 2022


CareStack’s detailed tracking of procedures, codes, and charges makes for more accurate accounting and a clearer picture of your practice’s financial health.  To that end, you’ll probably make more use of Adjustment Codes in CareStack than in your previous software. Adjustment codes are used to modify the split between carrier and patient or to identify changes in fees. Using specific codes allows your practice to move funds between the carrier and patient and to carefully track that movement and its consequences.  In CareStack, each adjustment represents an action to either increase or decrease the amount owed by the patient, by the insurance carrier, or both. In summary


An adjustment is a transaction that corrects or modifies the amount or details of a payment entry. Adjustment codes are used to apply adjustments to patient or insurance charges for them to get reflected correctly in the ledger. Adjustments could be used to write-off balance, to add on extra charges, or to transfer charges from patient to insurance or vice versa. In CareStack, Adjustment Codes are categorized into two:



Permissions


If you are not able to add or reverse an adjustment, then you wouldn’t be having the required permission. You can set the Permission from System menu > Practice settings > Administration > Profile > Manage Permissions > Billing > Adjustments

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Payment Adjustment - Custom Codes


How to Create an Adjustment Code?

You can create an Adjustment Code from System Menu > Practice Settings > Codes > Adjustment Codes > Add.  When you click on Add, a new blank grid appears where you need to enter the details and click on Save.

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PS: On the above picture, “Add” is greyed out as it was already clicked and you can also see a bank grid there to be completed.

Now let’s take a look into the field in each code.


Once you fill in all the details and click on Save, you get a green toaster as shown below indicating that the adjustment codes are added successfully to the system.


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To Edit an Adjustment Code, click on Edit, and all the fields except Code would be editable. Once you have made the corrections, you can go ahead and click o Save which will save the changes with a green toaster that says Adjustment codes updated successfully. 


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You can Deactivate an active plan (or vice versa) by clicking on Deactivate (or Activate) to the side of the corresponding code. Or if you want to Deactivate more than one code at a single go, then you may select the codes > Action > Deactivate.



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Payment Adjustment - System Codes


System codes are pre-defined adjustment codes. Let’s see one by one.

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System adjustment codes cannot be deleted or deactivated and none of its corresponding fields are editable.



Claim Adjustments


These codes describe why a claim or service line was paid differently than it was billed. These codes could be along with the ERA claim responses. The codes that are displayed here are:


Application of these codes can be seen by navigating to System menu > Electronic Remittance > Electronic Remittance Advice(ERA) > Select the Receipt > Click on the claim of the patient and there corresponding to the codes, you’d be able to see the Claim Adjustment codes.

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The explanation of the adjustment codes will also be given below on the same page.


The claim adjustment codes could also be seen under Pre-Authorization Remittance. There you can select the Pre-authorization and the patient and you’d be able to see the Adjustment codes, the adjustment amounts, and the explanation of the codes just like in ERA.

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Now that we have discussed the different adjustment codes and how to add them, we have to see where we need to apply these codes. So let’s think like this. Why do we need adjustments or where do we need to apply them? Yea.. you are correct, we apply them while making a payment- Patient Payments or Insurance Payments or you can simply add an adjustment to a procedure like a Production Adjustment.


Applying Payment Adjustments


Case 1: While posting Patient payments. Under Billing > Payments, you would be able to apply the adjustment for each code separately by: 

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Case 2: While posting Insurance payments. While posting Insurance Payments, we can apply adjustments for codes through multiple workflows. One way to post an adjustment would be while posting insurance payments at a line by selecting a receipt > Select the patient > Enter the amount > Click on and add an adjustment in the line level posting flow.

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Case 3: While posting Collection payments. While posting Collections Payments, we can apply adjustments for codes either as a Patient Adjustment or as Collection Commission both impacting just the patient's balance. 


Reversing Adjustments



From the Code Snapshot: If you want to reverse a wrongly posted adjustment, you could the procedure code on which the adjustment has been posted and then click the icon beside the adjustment row to reverse it. An adjustment can be reversed only if it is the last transaction that has been applied on that particular code. When you click on the ‘X’ mark, a confirmation pop-up comes on the screen. Click on Proceed Anyway to continue. 

Related image: ./carestack-questions-2023-03-02_files/1628016410383-1628016410383.png This reverses the Adjustment made against the code.


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Once the Adjustment is reversed, a green toaster could be seen on the top right which says that the transactions are reversed successfully.

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From the Code tab in the Right pane in the Insurance Payments screen: When posting payments at a line level, clicking on any of the editable fields of the code, you’d be able to see the payments made against the codes on the right pane under ‘Code’. From there, you can click on the ‘X’ mark to reverse the payments just as we discussed above.

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Partial Reversal


When an adjustment of action "Deduct from patient" or "Transfer to Insurance" is added to a procedure code, it should reduce the total patient receivables of that procedure code. Similarly, when an adjustment of action "Deduct from Insurance" or "Transfer to Patient" is added to a procedure code, it should reduce the insurance receivables of that procedure code. This should be done while posting adjustments while adding either patient, insurance or collection payments

If the posted payment amount exceeds the net receivable after posting adjustments, the excess payment amount should be reversed back into the original payment receipts. If payment was done using multiple receipts, the last applied ones will be reversed first.

Total of all Credit Adjustments > = Patient/Insurance Amount + Total of all Debit Adjustments. Total of "Deduct from Patient/Insurance" and "Transfer to Insurance/Patient" adjustments should not exceed the total receivables for that codes patient component. Total patient receivable is the sum of actual payable and all the "Add to Patient/Insurance", "Transfer to Patient/Insurance" adjustments against the code.

If Total of all Credit Adjustments < Patient/Insurance Amount + Total of all Debit Adjustments, then action would be blocked and a warning, 'The total adjustment amount is greater than the total patient/insurance receivable'.


Adjustment Code Defaults 


Unlike the payments screen, you would have noticed a difference while adding adjustments to Insurance payments. Yes, when you select the Adjustment Type an Adjustment code automatically fills in the Adj. Code column. This falls by default and this can be set under System menu > Practice settings > Payments > General > Others> Insurance Payment Posting Defaults. 

Here for each adjustment type, you would have a default adjustment code. You can make changes to that by clicking on Edit.


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In this picture, you would be able to see two other adjustment codes as well.

Default adjustment code for collection fee: The collection Commission in a collection Payment posting is added as an adjustment.  


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Default Adjustment code for Discount: This code is applied by default when we apply a discount to a code. This can be seen when we right-click on a recommended or proposed or accepted code > Apply discount > Select the discount Type as Amount.

Adjustment Code for Sales Tax: This code is applied when we sales tax is posted to a code. 


 

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Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


Adding an Insurance Carrier


Insurance Carriers are entered into the system from your Practice Settings. The carriers entered here will flow throughout CareStack's modules so you can easily select the intended carrier as needed throughout your daily workflows.

  1. From your system menu, select Practice Settings.
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  2. When the page loads, select Carriers on the left side menu. You'll see a list of all carriers that are currently in your CareStack database. (To update an existing carrier, locate it on the grid, then click it to open the carrier details)
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  3. Click the Add button in the upper-right corner to enter a new insurance carrier.
  4. Complete the details for the new insurance carrier:

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     5. If you'll be adding secondary addresses, carrier contact information, or eligibility template information at this time, click Save and Continue. This will allow to you enter the remaining information using the tabs on the left of the carrier window (detailed below).

Otherwise, click Save to save this record and move on with your tasks.


Carrier Details & Carrier Address

The information in these sections will have already been entered in the previous steps.

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Provider Insurance ID

This section will allow you to select the providers that have a contract with the insurance company.

  1. Click Edit > Add at the top right.
  2. Select the provider and location.
  3. Enter their assigned Insurance ID, Medicaid #, or Medicare # to be submitted along with their claims.
  4. Hit Save when you are done.

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Contact Details

This section allows you to store the contact information relevant to this plan.

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Eligibility Form

This tab allows you to create an Eligibility Form template at the carrier level. Setting eligibility rules provides more accurate fee estimations, as well as providing an alert message that may help the user while treatment planning.

When a new plan is entered into the system under a carrier that has an eligibility form template, the plan will inherit the eligibility rules. This relieves some of the work of entering this information from scratch when entering the new insurance plan; simply review and adjust the specifications as needed.

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1. Hit the Edit button at the bottom of the window to make your changes.

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2. On this grid, you will find the following columns:

3. Remember to hit Save when you are done.


Results

If one of the procedure codes has an alert and is treatment planned, a red  ( i )  icon will appear next to the code on the patient's chart:

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Clicking the icon will reveal the Alert message:

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Merge Insurance Carriers


If you find there are duplicate insurance carriers entered into the system, follow the steps below to merge them:

1. From your system menu, select  Practice Settings. 

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2. When the screen loads, select  Carriers on the left side menu, then click Merge Carriers at the top-right corner of the page. 

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3. In the pop-up window, select the carrier(s) that you want to merge and the destination carrier that they will merge with (destination carrier means it is this carrier the others will be consolidated into).

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4. Click Merge to continue. You will receive the following warning message: 

5. If you are sure you want to proceed, click Ok.
You will receive a green notification message at the top corner of the screen: Merged Successfully.

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Next Steps:

1. Search for your destination carrier on the grid and click it to review its details.

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2. Review the associated insurance plans and make sure they have the correct fee schedule assignments, or make a new fee schedule assignment.

Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


Your User Settings allow you to save your preferred contact information, set your default settings, create your preferred Scheduler filters, as well as enable phone plugins for integrated use. 

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Your User Settings will be organized into three tabs on the left-side panel:

General

On this tab:  Edit your contact info, update your login credentials, and choose your default settings. 

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User and Contact Details


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Defaults

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Scheduler Filter

On this tab, you are able to create your preferred Scheduler filters, allowing you to see only the necessary operatories for your daily workflows (such as when confirming/scheduling appointments, verifying eligibility, and so on).


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To create a new filter, follow the steps below:

1. Click Add at the top-right of the screen.  The following window will appear:


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2. Enter the preferred details for your new filter:

3. Hit Save when you are done.

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Phone

On this tab:  Enable a phone plugin (Jive or RingCentral) to integrate with your workflow in CareStack.

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  1. Select your Phone Plugin to enable it.
  2. Click Authorize Access (a window will pop-up).
  3. Enter your unique login credentials for the selected plugin.

Once this is complete, you can enable the setting to receive a call notification within your CareStack system, allowing you to easily access the patient's record.


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Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


1. To navigate to your Messages inbox, click on System Menu > Messages.

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2. Click Compose in the upper-left corner to start a new message.  The following window will appear:

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3. Hit Send at the bottom when you are finished. The notification icon will appear with a red indicator on the user's system menu.




Written by Renganathan K | Last published at: August 15, 2021


Brands


Branding to be used in the patient portal and kiosk. On the login and Identification page of the patient portal, we should be able to bring in branding on a group level.

In practice settings, we have a section called Brands to list/add/edit location groups.  Inside this section, the user will be able to define the group details and group assets along with a list of  locations which come under this brand. 

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Basic details of the brand will include details like name and contact info. Along with this, we will be  able to add locations to the brand (A location cannot be included inside multiple groups). Here, the user  will be able to enable branding on the patient portal / kiosk (Campaigns will be treated separately since  it is independent to PMS but it will be using the same branding provided here). Once we enable  branding for the patient portal, we will be able to generate and copy a URL that can be embedded on to  the practice website. All the patients redirected from this URL will see group level branding on the  patient portal.

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Brand Assets


All the branding related assets go here. These assets will be used for patient portal branding, or while resolving quick links inside patient engagement campaigns. They can choose a brand logo and update the image here. 


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Written by Megha Jayakumar | Last published at: June 01, 2022


Objective

 Periodontal charting is a way of measuring the space between a tooth and the gum tissue next to it. A dentist or dental hygienist uses an instrument called a probe and gently inserts it into this space. This probe has markings like a tape measure that shows them how deep it can reach into the space to check the health of your gums.

Users

Workflows

There are multiple ways in which you can start a new perio-chart in Carestack. 

The perio-chart page loads now. If no periodontal exams are recorded, the page will show “ No Prior Perio Examinations”.


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 Hit " Add" at the top-right. The following window will appear to fill in the exam details.

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ProviderSelect the treating provider for this perio-chart. By default, the priority is as follows : 

Location: Select the treatment location. By default, the patient's default location will be preselected.

Exam Date: The current date will be entered by default, or you can checkmark "Select a Previous Date" to select the previous date for this perio-exam.

 A new perio-chart gets added. The exam date, provider name, and location of the charting will be shown on top. 

Before inputting the measurements, the providers/dental assistants can take a look at the patient’s clinical history by clicking on the Clinical summary on the top right. This will open up the clinical slide-out which shows the Patient’s latest added prescription, lab cases, allergies and conditions, medications if any, medical history forms.

The ‘i’ icon below the clinical summary gives the users an idea about what each abbreviation stands for.

Add note will open up the clinical notes modal.

The print will print the perio-chart once the chart is finished or else the Print button will be greyed out.

You can record the following gum measurements into the system : 

1.Pocket Depth: Pocket Depth is the most important variable for evaluating the health of a pocket. PD is measured in millimeters from the gum line.PD is the most common measurement recorded.

PD will display in color on the chart if it meets or exceeds the alert depth specified in the Practice settings.

2.Gingival Margin: Gingival Margin is the area of the gingiva closest to the tooth surface, commonly referred to as the 'gum line'.

GM reflects the recession of the gum line. GM measures from the Cemento-Enamel Junction (CEJ).GM is assigned a positive value when the gum line is below the CEJ and a negative value when the gum line is above the CEJ. 

3.Clinical Attachment LevelCAL is a calculation of Pocket Depth and Gingival Margin: CAL=PD+GM. The CAL rating reflects the overall risk of losing the tooth. The higher the CAL number, the greater the chance of losing the tooth. 

4.Mucogingival Junction: MGJ is the meeting of the thick, protective gingival tissue around the teeth and the friable mucous lining of the cheeks and lips. MGJ concerns the health of the area where the gum tissue and cheeks meet.MGJ is assigned a value between 0-9.  

5.MobilityMOB is the amount of mobility a tooth has within its socket, and one of the following ratings is assigned to each tooth. MOB is assigned a value between 0-3. 

Grade 0: No apparent mobility 

Grade I: Slightly more than normal (<0.2mm horizontal movement)

Grade II: Moderately more than normal (1-2mm horizontal movement)

Grade III: Severe mobility (>2mm horizontal or any vertical movement) 

6.Furcation Grade: FG is the amount of tissue destruction in areas on a multi-rooted tooth where the roots diverge.FG is measured if the gums have receded enough to expose the roots.FG cannot be measured on anterior teeth because they only have one root.

FG is assigned grade ratings as follows:

   1 = Incipient bone loss.

   2 = Partial bone loss 

   3 =Total bone loss with through and through an opening of furcation.

   4 = Grade 3 with gingival recession exposing the furcation to view. 

7.Bleeding on probing: BoP refers to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus or interfaces between the gingiva and a tooth. BoP is a sign of periodontal inflammation and indicates some sort of destruction. 

8.Plaque: A sticky film that coats teeth and contains bacteria Dental plaque can damage a tooth and lead to tooth decay or tooth loss.

9.Suppuration: The production or discharge of PUS.

 

Enter the number of your measurements in the blue-highlighted box (pictured below). The chart may auto-advance to the next field to help you complete the chart faster (determined by your practice settings). The probing directions and site details are also configured in the practice settings. If a measurement of 10+ is required, Hold the ALT key then type the full number.To enter a negative gingival margin, Hold the ALT key then type the number.


There will be a note in the top left on editing a perio chart stating 'Press and hold alt key + number key to enter double digit'

The periodontal charting page is divided into four basic sections.

  1. Perio chart
  2. Numeric chart
  3. Perio graph
  4. Numeric comparison

1. PERIO CHART

There is a Measurement summary box on the right end of the page which captures the following details.

 Tooth #: Indicating the currently selected tooth

GM

CAL

MGJ

BOP

SUP

PL

MOB

Conditions

Missing: Marks the tooth as missing.

Impacted: Marks the tooth as impacted.

Hide 3rd molar: Hides the 3rd molar from Maxilla and Mandible region. 

Bleeding : This will open the tooth selector modal and can be used to mark bleeding on multiple teeth.

Interproximal bleeding: Conversion of bleeding to a non-bleeding state.

Bleeding All: Marks bleeding on all teeth.

 

 

The perio-chart will allow the users to enter the following probing measurements :

 Pocket depth (PD) ,Gingival Margin (GM), Mucogingival Junction(MGJ).

 

The probing measurements can be inputted into the respective fields by placing the cursor on the required teeth and on the required column or they can use the Measurement summary box on the right side of the page to key in the measurements. Either way, measurements can be recorded. Once it is selected, the selected box will be highlighted in Blue. Users can type in the probing measurements. A colored indication of the depth (based on the practice settings configuration ) will be shown alongside the teeth as you input the measurements. Once a value is entered, it automatically jumps to the next box selecting it in both places. If a measurement of more than 10 is required, hold the ALT key and then input the full measurements. If the inputted value exceeds the warning/danger level configured in the practice settings, the entries will be in Red.

 

BOP,SUP,FUR,PL can be inputted by using the measurement summary box on the right side where you can choose the tooth and input as required. Also, another way to indicate Bleeding on probing , Suppuration is by holding B & S when a pocket is selected. This will mark the bleeding sites/suppuration on the selected pocket.

MOB can be inserted here separately since Mobility is charted per tooth and not by surface 

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 If a tooth is marked missing / Hide 3rd molar, then the pocket depth boxes and tooth in the Perio chart page will be greyed out. While auto-advancing of pocket depth, the selector will skip if the tooth is greyed/check-boxes are greyed out. The same will be indicated in the patient’s odontogram with the condition added accordingly. If the Missing/Hide 3rd molar is unselected, the same will be removed from the odontogram as well.

There is a draw tool inside the perio chart which will let the user draw on the perio chart and the same will be shown in the perio chart print.


Also the dentititon shown in the perio chart will be the same shown in the charting page. That is if its a primary dentition, primary will be shown, if it is a permanent dentition, permanent will be shown.


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2. Numeric Chart

A numeric chart lets you enter all the charting measurements in a single page without the tooth representation in a single go. 

3. Perio Graph

This tab gives a graphical representation of your pocket depth measurements. Generates graphs based on the previous examination measurements which will help the clinical staff/providers in analyzing the patient's health over a period of time. This is ideal for a visual presentation to the patient. Values cannot be inputted/edited in this tab. 

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From the above image, the users can choose which measurements are to be compared. From the exam dropdown, the previous examination results can be selected to compare the present perio-chart data. 


4. Numeric comparison

This tab compares the measurements with the previous exam data in terms of numbers rather than the graphical representation. There is a print icon at the top right that will print the entire numeric comparison page. 

Once the measurements are recorded, navigate to the bottom of the chart and click on 'Finish' to save the measurements. 

'Cancel' will cancel the whole action. 'Reset' will reset the entire measurements recorded back to how it was created.

A finished perio-chart will be editable only for a day.(Based on the practice setting configuration) 

The next time a user tries to add another perio-chart, the latest perio-chart will be displayed by default along with the Exam date, provider associated with the charting, and the location at the top. Exam dropdown will list the previous exams in descending order. We can switch between the various exams using the exam drop-down. Now when a new Perio chart is added, there is an additional checkbox 'Copy from previous exam'. By default, it is unchecked. On checking the box, previous measurements will be copied to the chart and override the existing measurements if any. 

The comparison summary displayed at the bottom of the numeric chart is based on the standards defined by

The American Academy of Periodontology (AAP). 

Slight - 1- 2 mm

Moderate - 3-4 mm

Severe - >5mm

These are the ranges shown in the numeric chart comparison summary.


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Perio Charting Configuration

Basic perio-chart settings can be configured on a practice level. This is done by navigating to System menu > Practice settings > Clinical > Perio chart > Edit


1.Perio Chart



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Drop-down lists down the following four options :


2. Default Provider settings 


Impacts


 

 

 

 

 

 




Written by Sarah Abraham | Last published at: August 09, 2021


Overview

The dental imaging software provides dental practitioners and assistants with a platform for taking and storing dental x-rays and other images. The capabilities of these products can include imaging interfaces, patient browsers, and tools for enhancing image resolution. Dental assistants and dentists themselves will utilize these tools to properly photograph patient’s mouths, identify problem areas, map out procedure plans, and track treatment progress. Dental image software often integrates with a variety of cameras and imaging technology, as well as a dental practice management software to help store and organize patient dental records alongside their other information.

CareStack supports various cloud-based and desktop-based clinical software. The main ones are TigerView and SOTA.

Topics Covered in this Article


How to configure desktop-based clinical software


How to configure cloud-based clinical software

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How to view images from a cloud-based clinical software









Written by Sarah Abraham | Last published at: September 28, 2021


Overview

The SOTA Imaging bridge is a thrid party imaging software that we support. SOTA Imaging is one of the most efficient offering in the line of cloud-based digital imaging softwares for dental practices. Specifically designed to upload, view, edit, review, store, print, and share images easily and securely between locations, from anywhere in the world, via TLS DICOM.

Using SOTA

It can be configured for a practice by raising a ticket. SOTA credentials can be set up from the Services tab in Practice settings. Once it is enabled, the user can set up the username and password. These fields are mandatory. We also have the ability to add practice Id to the account as well.This would only be required in the case where there are more than one practice in the instance. 


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Now when user moves into chart and then clicks on 'Clinical Imaging', the images for the patient are shown as thumbnails. On clicking on the thumbnail or on 'Open imaging software', the SOTA cloud solution is opened. 


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Written by Nayana Netto | Last published at: August 16, 2021


Overview

Care Notes are pre-written notes that you’ll complete by answering prompt questions with pre-set response options -- just like a multiple-choice question. The notes can be set to launch automatically when certain treatments or conditions are charted. This trigger can be set to launch notes for conditions, or when treatment is planned, and/or completed.

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Once the user completes answering the responses, they can either finalize it or Save the note as Draft so that the doctor can review it. 

There are 2 ways by which care notes are added:

Step by step to add care note:

  1. From the charting page click on ‘+Note’.

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        2. Select the note template and from the required category.

        3. Click on Add note or user can multiselect notes and choose to merge them. 

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There are 2 modes: 

        4. Once the note is added, answer the prompt question with one or more of the available answer choices. You may be able to choose a single answer, multiple answers, or add custom text.

The note contains 3 sections:

Save as Draft: Allows you to save the answers and return to it later.

Finalize: Completes the note so that it cannot be edited or returned to later. If the note requires provider approval, it can only be finalized if the provider is logged in or available to enter the password.

Once finalized, you cannot modify the note, though an Addendum can be added. If you delete a note after it has been finalized, it will still show with a strikethrough.

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Editing a Care Note

A user can edit carenote until it is finalized. Edit button will let the user edit the content even if mandatory responses are skipped.

Note: Mandatory responses are the responses that cannot be left unanswered while finalizing a care note.

Upon clicking on Edit, the user can edit/delete the contents of the note. Any new responses or a whole new template can even be added to the selected note.

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Once all the required actions have been made, click on Update Note.

Setting up a template in practice settings:

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Setting up a response:

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Setting up a category:


Care Note Status

Care notes can be broadly classified as:

  1. Notes to be started: Notes in which not even a single response is answered.
  2. Notes to complete: Notes in which the user has started answering the response but not yet completed.
  3. Notes to review
  4. Finalized notes: Notes which are finalized.



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Care Note Merge Functionality

Users are given the flexibility to merge multiple care notes(Maximum 10). 

What happens while multiple notes are merged?

While notes are merged, they become a single note. All the responses and description of each note gets concatenated into the merged note. Primary note is an important part of merge functionality since some details of only the primary note are retained. These are :

In order to enable the Merge functionality there is an account level setting which needs to be turned on. System menu > Practice settings > Clinical > Care Notes > Settings > Enable Note Merge - Yes.

Notes can be merged as part of 3 workflows:

  1. +Note
  2. Code addition workflow
  3. Merging existing notes


1.  +Note 



2.  Code addition workflow

3. Merging existing notes

Linking Appointment to a Care Note

A user can link an appointment to a care note. This is to make sure that all the care notes are completed along with the appointment checkout process.

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Practice settings - Appointment settings

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Checking out an appointment: 



Reviewing Notes in the Dashboard

Notes that have been saved as a draft are collected in the Dashboard. You land on the Dashboard when you login to CareStack, or you can get there at any time by clicking the CareStack logo in the header bar.

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From there, open the notes section:

1. Select Clinical Notes.

2. Select the desired note from the slider.

The selected Care Note window will open. Any prompts that were already completed will be saved and shown in the window.

3. Complete the note as usual by answering the prompts with the pre-set answers and add any information as appropriate.

4. Click Finalize.

5. Click Yes in the warning window to complete and finalize the note.



Written by Sarah Abraham | Last published at: August 02, 2021


Overview

Care Audit Rules are instructions in order to assist the clinical practice users to select the appropriate treatments for the patients. For example, D0120, Periodic Evaluation, is mostly eligible for insurance, twice a year for a patient. Or if the practice user wrongly selects D1110 Adult Prophylaxis for a child, if appropriate Care Audit Rule was configured, then a message along with the alternative code will be listed. With the help of Care Audit Rules, the practices can create awareness among it’s users about this to help them make the appropriate treatments for their patients.

Topics Covered in this Article


How to set configure Care Audit Rules


Impact of Care Audit Rules in the practice workflow

Written by Sarah Abraham | Last published at: August 09, 2021


Overview

Smart Code is an intelligent treatment addition workflow in CareStack that ensures the correct treatment procedures are planned for the patient for the diagnosed conditions and thereby eliminates claim denial.

Smart Codes

The system will consider the following attributes for the smart code logic after Apply Smart Code Logic is set to “Yes”

For example, here in the below screenshot, the advanced code configuration of D2140 and D2150 is shown:


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 Now when the user tries to add procedure code D2140 to the patient record but selects two surfaces, then D2150 is added instead of D2140 as the system identifies the correct treatment.

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Here, in the image below we can see that the code is changed to D2150 as per smart code logic. 


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This feature thus helps reduce human error and intelligently ensures that the right kind of treatment is provided to the patient. 







Written by Sarah Abraham | Last published at: August 14, 2021


Overview

In the CareStack system, Clinical Lockout is what keeps your records intact by not allowing any further changes once it's been locked down. Some practices choose to do this monthly, that way all the records are verified correct and then locked down to prevent any further changes going into the next month.

Enabling Clinical Lockout
This setting can be found in your Practice Settings, then choose Clinical > Clinical Lockout on the left side menu.
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Once Clinical Lockout is Enabled:

Disabling Clinical Lockout

If disabling your Clinical Lockout feature that has previously been enabled, please be aware that your users (with the appropriate profile permissions) will be able to go back and update these clinical details that were previously locked down. This includes: procedure codes, tooth conditions, and clinical notes. The other items that would naturally be struck off from the dental chart while locked-down, users will now be able to delete those as usual once Clinical Lockout is disabled.

Written by Sarah Abraham | Last published at: December 13, 2021


Overview 

Dental recall is used to call the patient back for the completion of a sequence of procedures which are related to a certain treatment plan recommended by the provider. Recall exam appointments are regularly scheduled checkup appointments that help dentists to have an ongoing knowledge of the status of their patients. This exam is usually done after a regular interval by your Dentist. 


What is a recall?

A provider may examine the patient’s teeth and may perform some prerequisite procedures before performing the main procedure. Before the main procedure a waiting period might be required for the right conditions to perform the treatment. Hence, a feature called recall allows the system to automatically recall the patient for conducting the sequential procedure. These settings for the Treatment are set by the provider and would be applied whenever a particular treatment.

Setting up Recalls in Carestack

In practice settings under the Codes section, we have Recalls listed. We currently provide two types of recalls, procedure code as well as production type recalls. The users have options to trigger recalls based on the type of appointment completed (Production type) as well as when a certain type of procedure is completed (Procedure code).

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Here you can add a recall by clicking on the add button and a box would open as shown below.

Once the recall has been added. You’ll be able to see the recall type, procedures/ production type, corresponding recall and the duration of the recall listed in the Recalls subsection.

Adding Recalls to Patients

Let us consider an example of a patient who requires a Root canal for which an oral evaluation and a 3D image of the teeth are required as a prerequisite for the Root canal procedure. Here, the provider would have to complete the oral evaluation ( D0191) and the recall for the next procedure ( 3D image D0351) has to be made. For this the recall should be added and the duration should be specified. 

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Similarly we could configure a recall for the production type, cleaning. This would ensure that a patient comes in for a hygiene appointment at regular intervals. 

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Once we have set the recalls, we can add them to a patient. Recall can be added from 3 different places in the PMS

        1. +Recall button in the top bar.
        2. Account Summary in the Patient Overview an All recalls button exists 
        3. Appts > Recalls

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When adding a recall to a patient, the user can choose either the production type or procedure code. Depending on the type chosen, all the recalls under the type are listed. The user can choose the date and duration of recall as well as link an appointment. The Linked Appointment associates this recall to a scheduled appointment for that treatment or production type. Status shows whether the Recall is scheduled or unscheduled, if the recall is associated with an appointment then the status changes to Scheduled.

The Visit frequency can be changed for the recall but the corresponding due date will not change. Updating visit frequency, won’t update the due date of existing recalls, both in scheduled, unscheduled, and overdue status as changes would only impact recalls added afterward.

Updating the visit frequency for a particular recall, changes the recall duration on the patient level. So once the visit frequency is updated for a recall code, then existing recall’s due dates don’t change, but when adding a new recall for the same code, the new visit frequency set will be set as the duration.

 Even if the duration is changed for that recall code in the Practice Settings, the duration will still be the same as the updated visit frequency duration as this Patient Level change has precedence over the update in the practice settings.

Every time the procedure code linked to a recall is completed or a new appointment with production type linked to a recall is checked out, a new recall is added to the patient with a due date depending on the interval set. This would ensure that the patient is booked and visits the clinic at regular intervals.

Recall Status



Written by Megha Jayakumar | Last published at: August 16, 2021


Objective

Prescription slide-out is used by the providers/general users to prescribe medications to the patients.


Users


Workflows

 There are two ways in which you can access the prescription slide-out in carestack. One way is to use the +Presc quick link at the top or the Menu icon > Add prescriptions. This will open the prescription slide-out for the patient.


 The prescription slide-out will show the allergies and conditions of the patient along with the details of the current medication the patient is taking at the moment. The patient’s allergies and conditions are shown on the basis of the medical history form filled by the patient. The medications taken by the patient have to be entered manually in the prescription slide-out, so that whenever a clinical staff/another provider access this slide-out, they get an idea about the medications the patient is taking. 


To add an existing medication

To edit/delete an existing medication

 If no prescriptions are entered for the patient, the slide-out will display the message “ No prescriptions are added for this patient. Click to add a new prescription”.


Prescriptions can be added by the provider either in paper or send electronically using third party vendors ( DoseSpot )


1. Paper-Prescriptions


Once the prescriptions are added, it will display the following details in the Prescription History:


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2. Electronic-Prescriptions

 Electronic prescriptions are sent electronically to pharmacies by the use of a third-party vendor DoseSpot. DoseSpot is an E-prescribing platform integrated with our software which lets the practices prescribe medications electronically and save their time and paper.


To configure DoseSpot with your practice, the following are the steps required.


  1. Login to https://pss.dosespot.com/Admin/Account/Login to create the clinics for the practice
  2. The default/accessible locations given in the Google sheet(shared by each practice) are the clinics that you must add in Dosespot. The information about the locations can be obtained from System Menu > Practice settings > Locations.
  3. Once the clinic is added into DoseSpot, copy and paste the Clinic ID and Clinic key to the respective locations under System Menu > Practice settings > Services > DoseSpot > Configure > Locations. Set the location status to active in Carestack and Save.
  4. Once the locations are added, add the users in the google sheet shared by the practice either as a Prescriber or as a proxy user.User’s basic informations are available under System Menu > Practice settings > Administration > Users.
  5. Add the prescribing locations for a clinician 
  6. Once the details are entered, copy and paste the Clinician ID to System Menu > Practice settings > Services > DoseSpot > Configure > Users. This will activate the user in CareStack
  7. After this has been done, the Prescribing clinician will have to complete the TFA process and for a non-clinician profile, TFA is not required.
  8. Create a Jira ticket to enable DoseSpot services for the client and also create a DoseSpot salesforce ticket for URL Whitelisting.
  9. Once the DoseSpot services are configured and URL whitelisting is complete,DoseSpot becomes active for the client and they can start E-prescribing.
  10. If any one of the steps mentioned in 3,6,8,9 is missing, E-prescription button will not be visible 

To E-prescribe, please navigate to the Prescription slide-out either through the Menu icon or + Presc quick link.


To E-prescribe medications:

        1.Click the E-Prescribe button to link to DoseSpot and synchronize the patient profiles.

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          2. The DoseSpot prescription slide-out will appear

3.  In the DoseSpot iFrame, click the Add Prescription button.

4. Select the medication from the drop-down list including the medication strength if required.

5.Review or update the dispensing details as appropriate ( Effective date, Patient directions,Dispense, Refills)

            6. Click Save PrescriptionYou can repeat these steps to prescribe more than one medication.

            7. When you are finished prescribing, the added prescriptions will be shown in the Pending medications list.

            8. Select the prescription(s) to send and click Approve and Send.

       9. Modal will appear asking for the prescribing doctor’s Pin and Submit. The prescription will then be sent successfully   to the pharmacy.

          10. The electronic prescriptions will be listed down in the prescription history along with other paper prescriptions.


Set-Up

Impacts




Written by Nayana Netto | Last published at: September 06, 2021


Fee Calculation


SCOPE OF THIS DOCUMENT


FEE SCHEDULE

Fee schedules are tables which contain the list of procedure codes and fees that can be levied for those codes. Fee schedules can be created in three ways:

1. Manually entering the fees for required procedure codes.

2. Uploading a document in the required format.

3. Copying from an existing fee schedule and then editing.

A particular code may be present in multiple fee schedules with or without a difference in the fees against it. This difference may be due to the difference in:

1. Insurance carrier  

2. Insurance plan  

3. Plan type

4. Treatment provider

5. Treatment location

6. A combination of any of these factors.

When a fee schedule is created, we capture its name and type mandatorily and along with description which is optional. There are three types of fee schedules which can be created:

1. Max Allowable

2. HMO

3. UCR

Note: Earlier we had four types. Later PPO and Indemnity fee schedules were merged to form Max Allowable Fee Schedules.

(PPO – Preferred Provider Organization; HMO – Health Maintenance Organization; UCR – Usual Customary and Reasonable Fee.)

If the type chosen is Managed Care-HMO, then the fee for each code has to be entered as insurance and patient component in the columns “Ins. Amt” & “Pat. Amt” respectively.

For Max Allowable, the total fee is entered along with and AMB code if available. AMB (Alternative Minimum Benefit) code is a procedure code which the insurance carrier use to downgrade the insurance of the actual procedure. For example, the insurance carrier may downgrade the payment for a resin filling (costly) with that of an amalgam filling (cheaper).

In every fee schedule, regardless of the type, there is an additional column for capturing “Associate Codes” which are associated with the selected procedure code. In all fee schedules, there are options to enter future fees and a date when that fee becomes effective in replacing the current fees.

If the fee against a procedure code is not given, but an AMB code is given, then the fee of that AMB code can be considered as the fee of the actual procedure. But this is almost a non-existent scenario according to the available information.

Note: Fees is mandatory for procedures in fee schedules. The above-mentioned scenario can occur only through migrated data.


ASSIGNMENT 

Fee Schedules are not usable until they are assigned to a particular carrier, plan, provider, specialty, location, or any combination of these. There are certain rules which need to be satisfied when fee schedule assignment is done.

1. While assigning a fee schedule, the Carrier + Plan + Provider/ Specialty + Location + Type of Fee Schedule combination should always be unique.

2. Whenever a fee schedule is assigned to a combination involving plan, type of the plan and the type of the fee schedule should match.

3. If the Fee Schedule selected is of UCR type, then it should be assigned to a provider, location or a combination of both. i.e. no carrier or plan involved.

4. If the fee schedule selected is not of UCR type, then a plan or carrier is mandatory.

5. Any fee schedule can be assigned for a patient, but this is done in the patient’s page.

Note 1: Either a Provider or a Specialty is allowed. Both cannot be used together.

Note 2: PPO, Indemnity, Discount PPO and Co-pay should be considered as the same plan type in this context (point 2 above). i.e., It should be possible to assign any (and only) Max Allowable fee schedule to these plan types.

It is not mandatory to enter a carrier to assign a fee schedule to a combination of factors involving a plan. But when it gets saved, the carrier should be automatically saved along with it.

Since the type of fee schedule is also considered, a combination which involves a carrier (and without a plan) can have a Max Allowable Fee Schedule assigned to it and another HMO Fee Schedule assigned to it. This won’t happen if a plan is involved because if a plan is involved, the plan type has to match with fee schedule type.

HIERARCHY

Hierarchy is an order in which the system should check for fee schedules containing a particular procedure code. For example, if the first rule in the hierarchy is “Plan” and the second rule is “Provider”, then the fee schedule for the particular plan (if present) gets priority over the fee schedule assigned for the particular provider.

In other words: Hierarchy is an order set to fetch the most appropriate fee for a procedure code, from a fee schedule which correlates with the available details like – procedure code, carrier, plan, plan type, provider/specialty, and location.

There are two set of hierarchies namely “Estimation Hierarchy" and “Billing Hierarchy”.

An example of an Estimation Hierarchy is given below:

1. Fee Schedule assigned to a specific provider for an insurance plan for a specific location.

2. Fee Schedule assigned to a specific specialty for an insurance plan for a specific location.

3. Fee Schedule assigned to a specific provider for an insurance plan.

4. Fee Schedule assigned to a specific specialty for an insurance plan.

5. Fee Schedule assigned to a specific insurance plan for a specific location.

6. Fee Schedule assigned to a specific insurance plan.

7. Fee Schedule assigned to a specific carrier for a specific provider for a specific location.

8. Fee Schedule assigned to a specific carrier for a specific specialty for a specific location.

9. Fee Schedule assigned to a specific carrier for a specific provider.

10. Fee Schedule assigned to a specific carrier for a specific specialty.

11. Fee Schedule assigned to a specific carrier for a specific location.

12. Fee Schedule assigned to a specific carrier.

13. Fee Schedule assigned to a specific provider for a specific location.

14. Fee Schedule assigned to a specific specialty for a specific location.

15. Fee Schedule assigned to a specific provider.

16. Fee Schedule assigned to a specific specialty.

17. Fee Schedule assigned to a specific patient.

18. Fee Schedule assigned to a specific location.

An example of a Billing Hierarchy is given below:

1. Fee Schedule assigned to a specific provider for a specific location.

2. Fee Schedule assigned to a specific specialty for a specific location.

3. Fee Schedule assigned to a specific provider.

4. Fee Schedule assigned to a specific specialty.

5. Fee Schedule assigned for a specific location.

Note 1: The above hierarchies are used for the examples in this document.

Note 2: They may be different from the ones existing in the prototype or build.

Note 3: In the estimation hierarchy given above, Fee Schedules obtained for 13,14,15,16 & 18 will be of UCR type. 17 can be of any type. And the rest will be either Max Allowable or HMO types.

Note 4: Any fee schedules obtained via billing hierarchy may also be obtained via the estimation hierarchy, but it is not true conversely.


CALCULATION OF FEES

Fees are calculated after taking into consideration the available data and context. This is driven by the hierarchical setup.

Step 1: Identify the required hierarchy – Billing or Estimation hierarchy.

Billing Hierarchy is chosen in the following cases:

1. UCR fees are being calculated.

2. Billed amount is being calculated.

3. Fees are calculated for raising claims or pre-authorization request.

Estimation Hierarchy is chosen for every other scenario, for example:

1. To calculate the patient estimate and insurance estimate in treatment tabs.

2. This is used to calculate the patient payable and insurance payable in payments.

3. To calculate the fees shown in the grid in fee overlay.

Step 2: Find the applicable line in the chosen hierarchy. This is done as follows:

1. Take the first line in the chosen hierarchy and check if all the required details as required by the line are available. For example, If the hierarchy says “Fee Schedule assigned to a specific provider for an insurance plan for a specific location”, for choosing this the provider, location, and plan (in active status for the date of service) should be available.

2. If the required details are not available, then the next line in the hierarchy is checked and so on.

Step 3: Check for the fee schedule according to the applicable line in the hierarchy. This is done as follows:

1. If the applicable line is the third line of estimation hierarchy – “Fee Schedule assigned to a specific insurance plan for a specific location.”, then the plan, carrier, and location available are taken and made as a combination and a check will be done to see if a fee schedule is assigned for the exact same combination. It should also be ensured that the type of fee schedule thus obtained (if available) matches the plan type (HMO fee schedules for HMO plans, and Max Allowable for other plan types).

If the insurance plan type is PPO, Indemnity, Co-Pay or Discount, then the fees can be obtained only from Max. Allowable or UCR type fee schedules.

If the insurance plan type is HMO, then the fees can be obtained only from HMO or UCR type fee schedules.

Note 1: Here the carrier is taken from the plan details and added to create the combination, just as it was done in fee schedule assignment. This will create a consistency – the carrier will always be considered with the plan.

Note 2: Plan type is checked even if only the carrier is taken into consideration (without the plan) as is the case in lines 7,8,9,10,11 & 12 of the estimation hierarchy.

2. For the hierarchy line number 17 in the sample above, the patient’s page should be checked.

3. After obtaining the fee schedule, a check is done to see if the required code is available in that. If it is not available, then the next line of the hierarchy is considered, and so on until a fee is obtained or every line in the hierarchy is done with – whichever occurs first.

Step 4: Once the fee is obtained, split it into patient and insurance component if required according to the context. This following section explains how fee split is calculated for each of the plan types and what should happen if there is no plan. Also, the impact of AMB code, Deductibles, Plan maximums will be explained. Overall, fee calculation is a simple process with two steps. First is to find out the fees that can be charged and second is to split it into patient and insurance components.

PPO, Indemnity & Discount

1. When the fee for the required code is obtained from a Max Allowable type fee schedule, then the fee should be split to obtain the insurance and patient estimate according to what is set then at first, check if the code has a special coverage mentioned in the plan. If not check in the “Insurance Categories” inside the plan details of the patient. For example, if the amount obtained from the fee schedule is $100, and the coverage according to the insurance category is 75%, then the patient estimate is $25 and insurance estimate is $75.

Note 1: Insurance categories initially captured in the setup page can be overridden in the plan details of the patient.

Note 2: Insurance categories and ADA categories are different, with the latter holding no particular significance in fee calculation.

Note 3: Each plan may be using a different insurance category grouping which is set up in practice settings.

2. If the code is not present in any category and is not assigned a value inside the plan, it should be considered as zero percentage coverage. Then the entire amount should be populated as the patient estimate. In the case of PPO, Indemnity and Discount plan types, fee split can be taken even if the fees were obtained from UCR fee schedule. This is driven through settings.

3. If the fee for a procedure code is obtained from a fee schedule where there is a corresponding AMB code against it, the insurance estimate of the AMB code should be calculated and shown as the insurance estimate of the actual procedure. This amount should be reduced from the total amount of the actual code and shown as the patient estimate.

For example, if the actual code costs $250, with an AMB code against it which costs $100 (with a 50-50 split – which means the insurance will pay only $50), then the insurance estimate should be shown as $50 and the patient estimate should be $200 (250 - 50 = 200).

4. Whenever a patient component and insurance component is calculated, If there is a remaining deductible amount for the patient, in the scope of the current treatment plan to which the code is added AND if the deductible is not waived for the code, then deductible should be considered for fee calculation as explained below.

5. If no fee is obtained until the hierarchy is exhausted, “$0.00” should be populated as both patient and insurance component.

6. Whenever the fee is obtained using the billing hierarchy (claims and authorizations), it will be the UCR type (by design) and the fee is not split into any component.

Co-pay plan

Note: In the current implementation, the fee is capped to the value obtained from fee schedule in case the value from the table of allowance is higher than that in the fee schedule. This needs to be validated and maybe the table of allowance should be given more priority.

HMO

General Rules

Deductible Calculation

Also, In the bottom of treatment plans where the eligibility details are shown please show the value of "Rem. deductible" in red color when it is a non-zero value.

BILLING ORDER

Billing order gives the type of insurance (dental/medical) to which a procedure code should be raised in claims – primary claim, secondary, etc. If the billing order of a procedure is “DM”, it means that the primary claim for that code should be raised to a dental carrier and the secondary claim should be raised to a medical carrier.

The default billing order for a procedure code may be set in the setup page for codes as either of:

1. Bill to dental(D)

2. Bill to medical(M)

3. Bill to dental then medical(DM)

4. Bill to medical then dental(MD)

5. Do not bill to insurance(N)

This gets reflected in the treatment plan of a patient while adding the codes into it, but only after taking into consideration the existing insurances of the patient.

1. If the billing order says “Bill to dental” then the patient should have primary dental insurance. If not, no value will be displayed. i.e, “D” (Case insensitive). Possible values: D, DD, and N.

2. If the billing order says “Bill to medical” then the patient should have primary medical insurance. If not, no value will be displayed. i.e, “M”. Possible values: M, MM and N.

3. If the insurance says “Bill to dental then medical”, the patient should have primary dental and medical insurances. Billing order will be “DM”. If the patient has only primary dental insurance, then the billing order will be “D” and if not, then no value will be displayed. Possible values: D, DD, DM, DDM, DMM and N.

4. If the insurance says “Bill to medical then dental”, the patient should have primary medical and dental insurances. Billing order will be “MD”. If the patient has only primary medical insurance, then the billing order will be “M” and if not, then no value will be displayed. Possible values: M, MM, MMD, MDD, and N.

5. If the insurance is “Do not bill to insurance”, billing order will be “N”. Possible values: N.

Billing order can be overridden in the treatment planning modal window. Validation exists to ensure that the billing order matches with the existing insurances of the patient. Primary, secondary and subsequent claims for the codes are generated according to the billing order. Only codes with the same billing order are allowed on the same claim form. Billing order for a procedure in treatments can be edited only until the first claim is raised for that code. It becomes editable if that claim is void.

Billing order gives the type of carrier to which the claim should be sent. But the form on which the claim is raised depends also on the codes involved. The dental claim form (ADA 2012 or ADA 2002) can be used only for generating claims against dental codes to a dental carrier. For every other scenario, medical claim form CMS 1500 is used. Medical and custom codes (Codes with type 'Other') can be raised only in CMS 1500. It is also used for any claims to a medical carrier.

Note: The secondary claim doesn't necessarily mean that the claim is being raised to a secondary medical or secondary dental insurance. It just means that a claim is being raised to the carrier suggested by the second letter of the billing order.


FEE AUTO RE-CALCULATION

When this feature is turned on, the fees of every planned code gets automatically recalculated whenever a user visists the patient's clinical chart/advanced planner/appointment slide out when the codes are listed down. There is an account level setting to enable and disable automatic recalculation of fees for the account. 

Factors that may impact the existing fee - FEE UPDATION:

  1. Treatment level changes - Affecting only the patient
    • Updating Attributes of the Code
      • Changing Location or Provider of the code
      • Changing the Billing Order of the code
      • Changing Tooth #
      • Manual Fee updation
    • Altering the Treatment Plan and Code Order
      • Reordering of codes within a Tx. Plan
      • Moving of codes from one Tx. Plan to another (drag and drop + right-click)
      • Completing codes in incorrect order not as planned
      • Deleting & Rejecting Codes
    • Completing codes for other account members (Causing change in family max and ded values)
    • Linking to appointment and code completion
  2. INS. PLAN LEVEL CHANGES - Affecting only the patient subscribed to that instance of the ins plan
    • Changing the associated Insurance Plan
    • Updating the Insurance Plan Hierarchy
    • Updating Plan Benefits (Maximums, deductibles, dates)
    • Updating Eligibility - Limitations and Exclusions Rules - Benefit Remaining Checkbox
    • Updating effective and termination dates
    • Waiting period
  3. INS. PLAN LEVEL AND SETUP CHANGES - Affecting multiple patients using that plan
    • Updating Eligibility - Limitations and Exclusions Rules
    • Updating Coverage Values
    • Changing Plan Type
    • Changing Benefit Coordination Method and Use Fee Registers for Fee Calculation settings
    • Updating Insurance Category Groups
    • Updating AMB code section
    • Updating the Create Claim option
    • Updating Fee Schedule Assignments
    • Updating Fee Schedule Hierarchy
    • Updating the Fee Schedules / Table of Allowance / Fee Register values
    • Updating the Take percentage split for UCR type fee schedule
    • Automatic update to fee schedule values on reaching a particular date on which the future fee.


FEE LOCK

There is a feature to lock the fee of a code which is not in Completed, Referred Out and Referred Out Completed status would need to be added. 



Written by Megha Jayakumar | Last published at: December 13, 2021


Objective



The Lab cases are used to record and track the lab work being done for your patients. It shows the lab works, laboratories they were sent to, sent date, expected date of arrival, appointments linked etc for a patient.


Users




Workflows


If a patient’s treatment requires a lab, create a case to track the details. This case may be linked

to or separate from an appointment. To associate a lab:

  1. Select Appts in the patient navigation bar.
  2. Select Lab Cases.
  3. Click Add Lab Case.
  4. Complete the details about your lab case.
  5. Click Save or Save & Print

      

You can easily add lab details as you schedule the appointment with the built-in tools.

Other ways to add lab cases are by using the +Lab quick link at the top of the patient’s profile, by using the Add Lab case under the Menu icon from the patient’s profile and from System Menu > Lab cases. 


The added lab cases will be listed down in the order it was added, there is a delete and print option next to each lab case. Delete will delete the lab and delink it from the appointment if any. The print will print the lab case. While printing a lab case, Based on the Provider associated with the Lab Case, if that provider has a valid License # in the appointment location, then that value should be shown on the lab case print beneath the Provider's Name.If an appointment is not linked, then the license number associated with the Patient's Default Location should be shown on the lab case print. If no license number is available, then it should be left blank.


By default, received lab cases wouldn’t be shown. Once the checkbox is enabled, it will list down the received lab cases also. 


Set-Up




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Impacts








Written by Megha Jayakumar | Last published at: December 13, 2021


Procedure Codes


 A five-character alphanumeric code beginning with the letter “D” that identifies a specific dental procedure. Each procedure code is printed in boldface type in the CDT manual and cannot be changed or abbreviated. A dentist is also obligated to select the appropriate diagnosis code for patient records and claim submission


Workflows


Procedure codes 


 Users can configure any code-related settings in the System menu > Practice settings > Codes. This page will display the procedure codes added to the system so far. Procedure codes can be added or edited here. To add a new procedure code, click on Add. This will open the Add procedure code modal which contains the following fields : 




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Advanced code settings 


Once the above details are entered, click on Save and continue to move to the advanced code settings.



ICD Codes


 ICD code is a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs, and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.


 ICD codes can be added/edited through Practice Settings > Codes >ICD Codes. ICD codes can only be tagged against Procedure Codes. They are also shown in Claim Forms. They can be set as mandatory for a code in code settings.


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Touchpoints




Explosion Codes


 Procedure codes are specific and not usually done in isolation. For eg: Before doing a Filing, a cleaning code may be performed. Explosion codes are used to group these codes so that the user does not have to individually add them.

Explosion codes can be added/edited through Practice Settings > Codes > Explosion Codes.


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On clicking Add, the update explosion code modal appears. 


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Explosion codes can be edited/deleted from the same page. The list can also be sorted based on the name or date modified under the Actions.


Touchpoints



The above-mentioned touchpoints will vary with the new code addition workflow.



Recalls


 Procedure codes can be added/edited through Practice Settings > Codes > Recalls.

After the treatment is completed, patients enter the recall system, in which periodic dental appointments are established for the prevention and maintenance of dental health. Recalls give practices a steady flow of predictable income. Recalls can vary between 3- 24 months usually. 


Most services such as prophy, x-rays, and periodic oral evaluations are set as recall codes. Most insurance plans have these services free of cost for patients.

These codes are triggered once the base services are performed. 


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Touchpoints 












Written by Megha Jayakumar | Last published at: December 13, 2021


Objective 


 Treatment planning is used by Tx coordinators to prepare and plan tx plans for the patients once a condition is diagnosed. In large DSO’s, treatment coordinators prepare a well-detailed Treatment plan, divided into different phases and present it to the patients on chair.


Workflows



The advanced planner can be accessed from :



A new tx plan can be created by clicking on Create a treatment plan. A modal opens up with the following details :

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Once a tx plan has been created, it will be listed under the Grouped Treatments. By default, a tx plan will be created with a single phase. If the user wants to break it down into phases, they can click on the “ + “ icon to add a new phase into the plan.


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  1. Preview - To get a preview of the tx plan before presenting it to the patient
  2. Present with fee details - Presents the Tx plan to the patient  with the code estimates and adjustments made.(These details can vary based on the location Print settings under Practice settings > Locations > Print settings)
  3. Present without fee details - Presents the tx plan to the patient without any fee details.


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Impacts








    






Written by Megha Jayakumar | Last published at: September 28, 2021


Clinical Chart 

Clinical chart displays the patient’s odontogram where each condition or procedure codes added to individual tooth can be clearly differentiated based on the precedence order.

Users

Odontogram Dentition

 Permanent

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 Primary 

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Combination of Primary & Permanent

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Unerupted

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Default Dentition


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Tooth multi-selection through click and drag

Draw Toolbar

                             

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Dentition changer

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Legend


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Clicking on the Legend a pop up gets opened with four tabs

  1. Conditions
  2. Treatments
  3. Materials
  4. Tooth Chart Color
  5. CDT category

STS/NOR/CDT




BURST MODE/NORMAL MODE

Conditions

Treatments

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Surfaces

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Materials

Tooth Chart Colors

Patterns

Precedence

If multiple items of the same type(planned, completed...etc) are present on a single tooth, it will be layered in the latest added first order. 

Exceptions 


Code addition

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Chart Ledger



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Sorting order - Ascending and descending order based on DOS
                      -  No sorting based on created date

Sorting order -  Ascending and descending order based on DOS & No sorting which is entirely based on the created date

The odontogram representation of treatment codes will also change based on the chart   filter configuration


Clinical summary : -


Multiple actions can be performed against a code and a clinical note by selecting the checkbox and right clicking on the code :-



Care Panel

 One-click addition of items is possible with Care Panels in CareStack. It allows adding up to 30 tiles in each care panel between procedure codes, explosion codes, conditions, carenotes, forms, or letters. Based on the treatment categories, users can configure the most commonly used procedure codes,conditions,notes, forms, etc in each tile. 



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Touchpoints


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Written by Revati Krishnan | Last published at: August 09, 2022


Overview


Revenue cycle management(RCM) is a well‐known topic in the medical world, and it is slowly becoming seen as an important concept in the dental industry as well. It is the process used by healthcare systems in the United States to track the revenue from their patients from their initial appointment or encounter with the healthcare system to their final payment of balance. The cycle can be defined as, "all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.”  It is a cycle that describes and explains the life cycle of a patient (and subsequent revenue and payments) through a typical healthcare encounter from admission (registration) to final payment (or adjustment off of accounts receivables).

If the cycle is long, the cash is sitting in someone else’s bank account instead of yours, and the longer the cycle, the greater the likelihood that you’ll end up writing‐off some of the balance. Conversely, if the cycle is shorter, you receive payment faster, which of course, increases your revenue. Also, faster payments mean fewer collection problems and fewer write‐offs.

The medical billing process is not undertaken by a single individual. Medical coding involves front office administrators, such as receptionists, as well as back-office staff, including the medical biller and coder. The primary job of medical billing specialists is to:

These three primary tasks require many specific responsibilities within the medical billing process.


General RCM Workflow


Appointment Scheduling 

 Accuracy of Pre‐Treatment Estimates 

Claims Submission 

Insurance Payments 

Patient Billing 

By analyzing all the steps, and realizing that this cycle is repeated for every single insurance patient, it’s easy to see how things can fall through the cracks. Staffing properly for consistently good revenue cycle management can be daunting. There is typically a long learning curve to develop the knowledge and skills simply to perform the most basic of these tasks, much less dealing with any complications. And, who oversees the people performing these tasks? It’s usually not the dentist, since he or she probably doesn’t know how to manage all the steps. Unfortunately, in most practices, there is only one person managing the cycle – with little or no oversight. A typical solo office will have only one full time employee – or maybe even a part timer – handling all these tasks for hundreds of transactions in the cycle at any given time. Letting things slide – or just simple burn out – is not unusual.


References




Written by Revati Krishnan | Last published at: October 20, 2021


Revenue Cycle Management (RCM) encompasses getting paid for the work the office did.Though this focus seems to be more on collection activity, but in effective practice, it is much more a setup (fee schedules, exclusions, etc) and preparation (eligibility verification) activity.


At a high level, patients receive treatment/services in the dental practice and are charged for these services.  Since many patients have insurance, it is necessary to determine how much is to be paid by the patient, and how much is to be paid by insurance.  This process is estimation.  Based on the estimates, payment is taken from the patient in the office, and claims are sent off to the insurance company to be paid.  When the insurance company responds, the office will either post a payment, transfer the balance to the patient, post adjustment, resubmit the claim, or some combination of those.


When various aspects of the process fall apart - payment is not collected from the patient at the time of service or the claim is paid for less than expected - the office ends up with accounts receivable that must be managed.


Major Areas









Written by Revati Krishnan | Last published at: May 05, 2022


Glossary of key dental billing terms serve as a reference to help you get a better grasp on the language of this field. Check out the dental billing terminology definitions and explanations in the alphabetized list below:

A

ADA Dental Claim Form: The ADA Dental Claim Form provides a common format for reporting dental services to a patient's dental benefit plan. ADA policy promotes use and acceptance of the most current version of the ADA Dental Claim Form by dentists and payers.

Allowed Amount: The sum an insurance company will reimburse to cover a healthcare service or procedure. The patient typically pays the remaining balance if there is any amount left over after the allowed amount has been paid. This amount should not to be confused with co-pay or deductibles owed by a patient.

American Dental Association (ADA): The ADA is a not-for-profit organization working to power the profession of dentistry on the national, state and local level. There are 162,000 ADA members representing all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands.  Membership in the national organization includes membership in one of our 53 state and 545 local dental societies.  A member-run organization, the ADA is managed by an elected Board of Trustees and governed by a 483-member House of Delegates.

American Medical Association (AMA): The AMA is the largest organization of physicians in the U.S. dedicated to improving the quality of healthcare administered by providers across the country. The current procedural technology (CPT) code set is maintained and revised by the AMA in accordance with federal guidelines.

Aging: A formal medical billing term that refers to insurance claims that haven’t been paid or balances owed by patients overdue by more than 30 days. Aging claims may become denied if they aren’t filed in time with a health insurance company.

Ancillary Services: Any service administered in a hospital or other healthcare facility other than room and board, including biometrics tests, physical therapy, and physician consultations among other services.

Appeal: Appeal occurs when a patient or a provider tries to convince an insurance company to pay for healthcare after it has decided not to cover costs for someone on a claim. Medical billing specialists deal with appeals after a claim has been denied or rejected by an insurance company.

Applied to Deductible (ATD): This term refers to the amount of money a patient owes a provider that goes to paying their yearly deductible. A patient’s deductible is determined by their insurance plan and can range in price.

Assignment of Benefits (AOB): This term refers to insurance payments made directly to a healthcare provider for medical services received by the patient. Assignment of benefits occurs after a claim has been successfully processed with an insurance company.

Application Service Provider (ASP): ASP is a digital network that allows healthcare providers to access quality medical billing software and technologies without needing to purchase and maintain it themselves. Providers who use ASP typically pay a monthly fee to the company that maintains the billing software.

Authorization: This term refers to when a patient’s health insurance plan requires them to get permission from their insurance providers before receiving certain healthcare services. A patient may be denied coverage if they see a provider for a service that needed authorization without first consulting the insurance company.

B

Beneficiary: The beneficiary is the person who receives benefits and/or coverage under a healthcare plan. The beneficiary of an insurance plan may not be the person paying for the plan, as is the case for young children covered under their parents’ plans.

Blue Cross Blue Shield: Blue Cross Blue Shield is a federation of 38 health insurance companies in the U.S. (some of which are non-profit companies) that offer health insurance options to eligible persons in their area. Blue Cross Blue Shield offers healthcare plans to over 100 million people in the U.S.

C

Capitation: Capitation fee, or capitation rate, is the fixed amount paid from an insurer to a provider. This is the amount that is paid (generally monthly) to cover the cost of services performed for a patient. Capitation fees can be lower in higher population areas. A capitation is different from a deductible or co-pay.

Clean Claim: This refers to a medical claim filed with a health insurance company that is free of errors and processed in a timely manner. Some providers may send claims to organizations that specialize in producing clean claims, like clearinghouses.

Clearinghouse: Clearinghouses are facilities that review and correct medical claims as necessary before sending them to insurance companies for final processing. This meticulous editing process for claims is known in the medical billing industry as “scrubbing.”

Centers for Medicare and Medicaid Services (CMS): The CMS is the federal entity that manages and administers healthcare coverage through Medicare and Medicaid. CMS coordinates with providers and enrollees to provide healthcare to over 100 million Americans.

CMS 1500: The CMS 1500 is a paper medical claim form used for transmitting claims based on coverage by Medicare and Medicaid plans. Commercial insurance providers often require that providers use CMS 1500 forms to process their own paper claims.

Code on Dental Procedures and Nomenclature (CDT Code): The purpose of the CDT Code is to achieve uniformity, consistency and specificity in accurately documenting dental treatment. One use of the CDT Code is to provide for the efficient processing of dental claims, and another is to populate an Electronic Health Record. On August 17, 2000 the CDT Code was named as a HIPAA standard code set. Any claim submitted on a HIPAA standard electronic dental claim must use dental procedure codes from the version of the CDT Code in effect on the date of service. The CDT Code is also used on paper dental claims, and the ADA's paper claim form data content reflects the HIPAA electronic standard.

Coding: Coding is the process of translating a physician’s documentation about a patient’s medical condition and health services rendered into medical codes that are then plugged into a claim for processing with an insurance company. Medical billing specialists must be familiar with many code sets in order to perform their job duties.

Co-Insurance: The percentage of coverage that a patient is responsible for paying after an insurance company pays the portion agreed upon in a health plan. Co-insurance percentages vary depending on the health plan.

Collection Ratio: This refers to the ratio of payments received relative to the total amount owed to providers.

Contractual Adjustment: This refers to a binding agree between a provider, patient, and insurance company wherein the provider agrees to charges that it will write off on behalf of the patient. Contractual adjustments may occur when there is a discrepancy between what a provider charges for healthcare services and what an insurance company has decided to pay for that service.

Coordination of Benefits (COB): COB occurs when a patient is covered by more than one insurance plan. In this situation one insurance company will become the primary carrier and all other companies will be considered secondary and tertiary carriers that may cover costs left after the primary carrier has paid.

Co-Pay: A patient’s co-pay is the amount that must be paid to a provider before they receive any treatment or services. Co-pays are separate from a deductible, and will vary depending on a person’s insurance plan.

Current Procedural Technology (CPT) Code: CPT codes represent treatments and procedures performed by a physician in a 5-digit format. CPT codes are entered together with ICD-9 codes that explain a patient’s diagnosis. Medical billing specialists will enter CPT codes into claims so insurance companies understand the nature of healthcare a patient received with a provider.

Credentialing: The application process for a provider to coordinate with an insurance company. Once providers have become credentialed with an insurance company, they have the opportunity to work with that company in providing affordable healthcare to patients.

Credit Balance: Refers to the sum shown in the “balance” column of a billing statement that reflects the amount due for services rendered.

Crossover Claim: When claim information is sent from a primary insurance carrier to a secondary insurance carrier, or vice versa.

D

Date of Service (DOS): The date when a provider performed healthcare services and procedures.

Day Sheet: A document that summarizes the services, treatments, payments, and charges that a patient received on a given day.

Deductible: The amount a patient must pay before an insurance carrier starts their healthcare coverage. Deductibles range in price according to terms set in a person’s health plan.

Demographics: The patient’s information required for filing a claim, such as age, sex, address, and family information. An insurance company may deny a claim if it contains inaccurate demographics.

Date of Birth (DOB): The exact date a patient was born.

Downcoding: Downcoding occurs when an insurance company finds there is insufficient evidence on a claim to prove that a provider performed coded medical services and so they reduce or remove those codes. Downcoding usually reduces the cost of a claim.

Duplicate Coverage Inquiry (DCI): A formal request typically submitted by an insurance carrier to determine if other health coverage exists for a patient.

Dx: The abbreviation for diagnosis codes, also known as ICD codes.

E

Electronic Claim: A claim sent electronically to an insurance carrier from a provider’s billing software. The format of electronic claims must adhere to medical billing regulations set forth by the federal government.

Electronic Funds Transfer: A method of transferring money electronically from a patient’s bank account to a provider or an insurance carrier.

Electronic Medical Records (EMR): EMR is a digitized medical record for a patient managed by a provider onsite. EMRs may also be referred to as electronic health records (EHRs).

Enrollee: A person covered by a health insurance plan.

Explanation of Benefits (EOB): A document attached to a processed medical claim wherein the insurance company explains the services they will cover for a patient’s healthcare treatments. EOBs may also explain what is wrong with a claim if it’s denied.

Electronic Remittance Advice (ERA): The digital version of EOB, which specifies the details of payments made on a claim either by an insurance company or required by the patient.

ERISA: Stands for the Employee Retirement Income Security Act of 1974. This act established guidelines and requirements for health and life insurance policies including appeals and disclosure of grievances.

F

Fee for Service: This refers to a type of health insurance wherein the provider is paid for every service they perform. People with fee-for-service plans typically can choose whatever hospitals and physicians they want to receive care in exchange for higher deductibles and co-pays. (Concept of Indemnity or Point-of-sale)

Fee Schedule: A document that outlines the costs associated for each medical service designated by a CPT code.

Financial Responsibility: Whoever owes the healthcare provider money has financial responsibility for the services rendered. Insurance companies or patients themselves may be financially responsible for the costs associated with care, and these responsibilities are typically outlined in a healthcare plan contract.

Fiscal Intermediary (FI): The name for Medicare representatives who process Medicare claims.

Formulary: A table or list provided by an insurance carrier that explains what prescription drugs are covered under their health plans.

Fraud: Providers, patients, or insurance companies may be found fraudulent if they are deliberately achieving their ends through misrepresentation, dishonesty, and general illegal activity. Medical billing specialists who deliberately enter incorrect or misleading information on claims may be charged with fraud.

G

Group Health Plan (GPH): A plan provided by an employer to provide healthcare options to a large group of employees.

Group Name: The name of the group, insurance carrier, or insurance plan that covers a patient.

Group Number: A number given to a patient by their insurance carrier that identifies the group or plan under which they are covered.

Guarantor: The party paying for an insurance plan who is not the patient. Parents, for example, would be the guarantors for their children’s health insurance.

H

Healthcare Financing Administration: The former name for what is now the CMS.

Healthcare Financing Administration Common Procedure Coding System (HCPCS): HCPCS is a three-tier coding system used to explain services, devices, and diagnoses administered in the healthcare system. Medical billing specialists utilize codes in the HCPCS on a daily basis to file claims.

Healthcare Insurance: This is insurance offered to a group or an individual to cover costs associated with medical care and treatment. Those covered by healthcare insurance typically must pay a premium for their plans in addition to various co-pays and/or deductibles.

Healthcare Provider: These are the entities that offer healthcare services to patients, including hospitals, physicians, and private clinics, hospices, nursing homes, and other healthcare facilities.

Healthcare Reform Act: The major healthcare legislation passed in 2010 designed to make healthcare accessible and less expensive for more Americans.

Health Insurance Claim: The unique number ascribed to an individual to identify them as a beneficiary of Medicare.

Health Insurance Portability and Accountability Act (HIPAA): HIPAA was a law passed in 1996 with an aim to improve the scope of healthcare services and establish regulations for securing healthcare records from unwanted parties.

Health Maintenance Organization (HMO): HMOs are networks of healthcare providers that offer healthcare plans to people for medical services exclusively in their network.

Hospice: This refers to medical care and treatment for persons who are terminally ill.

I

ICD-9 Codes: ICD-9 codes are an international set of codes that represent diagnoses of patients’ medical conditions as determined by physicians. Medical billing specialists may translate a physician’s diagnoses into ICD-9 codes and then input those codes into a claim for processing.

ICD-10 Codes: ICD-10 codes are the updated international set of codes based on the preceding ICD-9 codes. ICD-10 codes are estimated to be mandatory in the American healthcare system by October 2014.

Indemnity: A type of health insurance plan whereby a patient can receive care with any provider in exchange for higher deductibles and co-pays. Indemnity is also known as fee-for-service insurance.

In-Network: This term refers to a provider’s relationship with a health insurance company. A group of providers may contract with an insurance company to form a network of healthcare professionals that a person can choose from when enrolled in that insurance company’s health plan.

Inpatient: Inpatient care occurs when a person has a stay at a healthcare facility for more than 24 hours.

Independent Practice Association (IPA): The IPA is a professional organization of physicians who have a contract with an HMO.

Intensive Care: Intensive care is the unit of a hospital reserved for patients that need immediate treatment and close monitoring by healthcare professionals for serious illnesses, conditions, and injuries.

M

Medicare Administrative Contractor (MAC): MACs are contract with the federal government to process Medicare claims.

Managed Care Plan: A health insurance plan whereby patients can only receive coverage if they see providers who operate in the insurance company’s network.

Maximum Out of Pocket: The amount a patient is required to pay. After a patient reaches their maximum out of pocket, their healthcare costs should be covered by their plan.

Medical Assistant: An employee in the healthcare system such as a physian’s assistant or a nurse practitioner who perform duties in administration, nursing, and other ancillary care.

Medical Coder: A medical coder is responsible for assigning various medical codes to services and healthcare plans described by a physician on a patient’s superbill.

Medical Billing Specialist: A medical billing specialist is responsible for using information regarding services and treatments performed by a healthcare provider to complete a claim for filing with an insurance company so the provider can be paid.

Medical Necessity: This term refers to healthcare services or treatments that a patient requires to treat a serious medical condition or illness. This does not include cosmetic or investigative services.

Medical Record Number: A unique number ascribed to a person’s medical record so it can be differentiated from other medical records.

Medicare Secondary Payer: The insurance company that covers any remaining expenses after Medicare has paid for a patient’s coverage.

Medical Savings Account (MSA): An MSA is an optional health insurance payments plan whereby a person apportions part of their untaxed earnings to an account reserved for healthcare expenses. A person with an MSA can only contribute a certain amount of their earnings per year. Any unused funds in an MSA at the end of the year will roll over to the next.

Medical Transcription: The process of converting dictated or handwritten instructions, observations, and documentation into digital text formats.

Medicare: Medicare is a government insurance program started in 1965 to provide healthcare coverage for persons over 65 and eligible people with disabilities.

Medicare Coinsurance Days: Referring to 61st through 90th days of inpatient treatment, the law requires that patients pay for a portion of their healthcare during Medicare coinsurance days.

Medicaid: Medicaid is a joint federal and state assistance program started in 1965 to provide health insurance to lower-income persons. Both state and federal governments fund Medicaid programs, but each state is responsible for running its own version of Medicaid within the minimum requirements established by federal law.

Medigap: Medigap is supplemental health insurance under Medicaid for eligible persons who need help covering co-pays, deductibles, and other large fees.

Modifier: Modifiers are additions to CPT codes that explain alterations and modifications to an otherwise routine treatment, exam, or service.

N

Non-Covered Charge (N/C): N/Cs are procedures and services not covered by a person’s health insurance plan.

Not Elsewhere Classifiable (NEC): A term used to describe a procedure or service that can’t be described within the available code set.

Network Provider: A provider within a health insurance company’s network that has contracted with the company to provide discounted services to a patient covered under the company’s plan.

Non-participation: This is when a provider refuses to accept Medicare payments as a sufficient amount for the services rendered to a patient.

Not Otherwise Specified (NOS): This term is used in ICD-9 codes to describe conditions with unspecified diagnoses.

National Provider Identifier (NPI) Number: A unique 10-digit number ascribed to every healthcare provider in the U.S. as mandated by HIPAA.

O

Office of Inspector General (OIG): The organization responsible for establishing guidelines and investigating fraud and misinformation within the healthcare industry. The OIG is part of the Department of Health and Human Services.

Out-of-Network: Out-of-network refers to providers outside of an established network of providers who contract with an insurance company to offer patients healthcare at a discounted rate. People who go to out-of-network providers typically have to pay more money to receive care.

Outpatient: This term refers to healthcare treatment that doesn’t require an overnight hospital stay, including a routine visit to a primary care doctor or a non-invasive surgery.

P

Patient Responsibility: This refers to the amount a patient owes a provider after an insurance company pays for their portion of the medical expenses.

Primary Care Physician (PCP): The physician who provides the basic healthcare services for a patient and recommends additional care for more serious treatments as necessary.

Point of Service Plans: A plan whereby patients with HMO membership may receive care at non-HMO providers in exchange for a referral and paying a higher deductible.

Place of Service Code: A two-digit code used on claims to explain what type of provider performed healthcare services on a patient.

Preferred Provider Organization (PPO): A plan similar to an HMO whereby a patient can receive healthcare from providers within an established network set up by an insurance company.

Practice Management Software: Software used for scheduling, billing, and recordkeeping at a provider’s office.

Preauthorization: Some insurance plans require that a patient receive preauthorization from the insurance company prior to receiving certain medical services to make sure the company will cover expenses associated with those services.

Pre-Certification: A process similar to preauthorization whereby patients must check with insurance companies to see if a desired healthcare treatment or service is deemed medically necessary (and thus covered) by the company.

Pre-determination: A maximum sum as explained in a healthcare plan an insurance company will pay for certain services or treatments.

Pre-existing Condition (PEC): PEC is a medical condition a patient had before receiving coverage from an insurance company. A person might become ineligible for certain healthcare plans depending on the severity and length of their PEC.

Pre-exisiting Condition Exclusion: The existence of a PEC denies a person certain coverage in some health insurance plans.

Premium: The sum a person pays to an insurance company on a regular (usually monthly or yearly) basis to receive health insurance.

Privacy Rule: Standards for privacy regarding a patient’s medical history and all related events, treatments, and data as outlined by HIPAA.

Provider: A provider is the healthcare facility that administered healthcare to an individual. Physicians, clinics, and hospitals are all considered providers.

Provider Transaction Access Number (PTAN): This refers to a provider’s current legacy provider number with Medicare.

R

Referral: This is when a provider recommends another provider to a patient to receive specialized treatment.

Remittance Advice (R/A): The R/A is also known as the EOB, which is the document attached to a processed claim that explains the information regarding coverage and payments on a claim.

Responsible Party: The person who pays for a patient’s medical expenses, also known as the guarantor.

Revenue Code: A three-digit code used on medical bills that explains the kind of facility in which a patient received treatment.

Relative Value Amount (RVA): The median amount Medicare will repay a provider for certain services and treatments.

S

Scrubbing: A process by which insurance claims are checked for errors before being sent to an insurance company for final processing. Providers scrub claims in an attempt to reduce the number of denied or rejected claims.

Self-Referral: When a patient does their own research to find a provider and acts outside of their primary care physician’s referral.

Self-Pay: Payment made by the patient for healthcare at the time they receive it at a provider’s facilities.

Secondary Insurance Claim: The claim filed with the secondary insurance company after the primary insurance company pays for their portion of healthcare costs.

Secondary Procedure: This is when provider performs another procedure on a patient covered by a CPT code after first performing a different CPT procedure on them.

Security Standard: The security standard serves as the guidelines for policies and practices necessary to reduce security risks within the healthcare system. The security standard policies work in concert with the security guidelines set in place with the passage of HIPAA.

Skilled Nursing Facility: These are facilities for the severely ill or elderly that provide specialized long-term care for recovering patients. Skilled nursing facilities are alternative healthcare establishments to extended hospital stays and may be covered by eligible patients’ insurance policies.

Signature on File (SOF): A patient’s official signature on file for the purpose of billing and claims processing.

Software as a Service (SAAS): Medical billing software hosted off site by another company and only accessible with Internet access. SAAS is useful for providers who don’t want to maintain and update in-house medical billing software.

Specialist: A physician or medical assistant with expertise in a specific area of medicine. Oncologists, pediatricians, and neurologists are among the many specialists in the medical field.

Subscriber: The subscriber is the individual covered under a group policy. For instance, an employee of a company with a group health policy would be one of many subscribers on that policy.

Superbill: A document used by healthcare staff and physicians to write down information about a patient receiving care. The superbill can contain demographic information, insurance information, and especially any diagnoses or healthcare plans written by the physician. A medical billing specialist inputs the information on a patient’s superbill into a claim.

Supplemental Insurance: Supplemental insurance can be a secondary policy or another insurance company that covers a patient’s healthcare costs after receiving coverage from their primary insurance. Supplemental insurance policies typically help patients cover expensive deductibles and copays.

T

Treatment Authorization Request (TAR): A unique number the insurance company gives the provider for billing purposes. A provider must receive the insurance company’s TAR number before administering healthcare to a patient covered by the company.

Taxonomy Code: Medical billing specialists utilize this unique codeset for identifying a healthcare provider’s specialty field.

Term Date: The end date for an insurance policy contract, or the date after which a person no longer receives or is no longer eligible for health insurance with company. Term dates are typically determined on a case-by-case basis.

Tertiary Insurance Claim: A claim filed by a provider after they have filed claims for primary and secondary health insurance coverage on behalf of a patient. Tertiary insurance claims often cover the remaining healthcare costs such as deductibles and co-pays left over after the primary and secondary claims have been processed.

Third Party Administrator (TPA): The name for the organization or individual that manages healthcare group benefits, claims, and administrative duties on behalf of a group plan or a company with a group plan.

Tax Identification Number (TIN): A unique number a patient or a company may have to produce for billing purposes in order to receive healthcare from a provider. The TIN is also known as the employment identification number (EIN).

Triple Option Plan (TOP): Also referred to as the cafeteria plan, this plan gives an enrolled individual the options to choose between an HMO, a PPO, or a traditional point of service plan for their health insurance. Some companies offer triple option plans to their employees to accommodate the needs of a diverse staff.

Type of Service (TOS): A field on a claim for describing what kind of healthcare services or procedures a provider administered.

TRICARE: TRICARE is the federal health insurance plan for active service members, retired service members, and their families, in addition to survivors of service members. TRICARE was previously known as CHAMPUS.

U

UB04: A form used by providers for filing claims with insurance companies. The UB04 form has a format similar to that of the CMS 1500 form.

Unbundling: This term refers to the fraudulent practice of ascribing more than one code to a service or procedure on a superbill or claim form when only one is necessary.

Untimely Submission: Claims have a specific timeframe in which they can be sent off to an insurance company for processing. If a provider fails to file a claim with an insurance company in that timeframe, it is marked for untimely submission and will be denied by the company.

Upcoding: Upcoding is the fraudulent practice of ascribing a higher ICD-9 code to a healthcare procedure in an attempt to get more money than necessary from the insurance company or patient.

Unique Physician Identification Number (UPIN): A unique six-digit identification number given to physicians and other healthcare personnel, which has subsequently been replaced by a national provider identifier (NPI) number.

Usual Customary and Reasonable (UCR): The UCR is the amount of money stipulated in a contract that an insurance company agrees to pay for healthcare costs. After passing the UCR a patient is typically responsible for covering their healthcare costs.

Utilization Limit: The limit per year for coverage under certain available healthcare services for Medicare enrollees. Once a patient passes the utilization limit for a service, Medicare may no longer cover them.

Utilization Review (UR): An investigation or audit performed to optimize the number of inpatient and outpatient services a provider performs.

W

Worker’s Compensation: Worker’s compensation is paid by an employer when an employee becomes ill or injured while performing routine job duties. Most states have laws requiring that companies provide worker’s compensation.

Write-Off: This term refers to the discrepancy between a provider’s fee for healthcare services and the amount that an insurance company is willing to pay for those services that a patient is not responsible for. The write-off amount may be categorized as “not covered” amounts for billing purposes.

Written by Rahul Krishnan | Last published at: August 02, 2022


Migrated Balances


Overview

As you transitioned to CareStack from another software, you tried to collect insurance and patient  balances and close accounts. Yet some of those patients and carriers didn’t pay before it was time to  let that software go. Your practice had to decide what to do with those leftover balances. 

In some cases, whatever was left to pay may have been transferred to CareStack as a general  balance, shown in CareStack as an MSB (Migrated Starting Balance). In other cases, those balances  were left behind so you could start fresh. 

Without the MSB, you would need to add a code/charge to create a balance deficit for the patient and apply the patient payment for the newly added code but doing so will inflate your production. If you ignore the credit that the patient owes the practice, your collections are off. Instead, CareStack lets you apply the payment to the migrated balance -either one that was brought over, or one you create.


Create a Migrated Balance 

When your practice didn’t migrate balances, or you received a payment on a balance that was not  migrated, you can create your own migrated balance transaction. It will reflect what was owed in  your legacy system but not inflate your production. Apply your new credits against that balance and  everything matches and reflects correctly in your financial records. 

You can create the migrated balance entry wherever you are working in the patient’s financial record,  including the Ledger, Insurance Payment module or Patient Payment slider.  

Each entry would apply to only one provider and one location, so you may need to create more than one balance code. It helps keep the financial records straight.  


Allocate an Insurance Payment to an MSB

Allocate an insurance payment to a migrated balance in much the same way you allocate an  insurance payment to a current claim, you just use a slightly different tab. 


Shown below is an example of an insurance payment posting where the insurance paid amount matches the MSB balance in which case there is no need for any adjustments.


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Allocate an Insurance Payment to an MSB

If the Allowed Amount from the EOB does NOT match the Allowed Amount in CareStack, you’ll need to add an adjustment to account for the difference. This will be a separate adjustment.

1.If the insurance amount is less than the Balance due Insurance, there is an underpayment and the difference amount will be highlighted in red color. You can either transfer the deficient balance back to the patient or write off the difference amount in this scenario. You can choose any one of these two actions and the appropriate adjustment codes will be applied to the difference amount.



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2. If the insurance amount is more than the Balance due Insurance, there is an overpayment by the insurance company and the excess amount will be shown in green. In case of an overpayment you can choose any of the following actions.

Credit to Patient and Apply- The excess amount will be transferred as patient unapplied credits.


Increase Insurance Allowable and Apply- Insurance Adj On adjustment will be triggered which will increase the insurance balance for the MSB code so as to make up for the difference in amounts. This can be done in case the excess amount need not be transferred to the patient as credits.


Increase Ins & Pat Allowable and Apply- The Ins Adj On and the Pat Adj On adjustments will be triggered. The difference in amounts can be counterbalanced by a combined increase in the patient balance as well as the insurance balance.


Transfer balance from Patient- A transfer adjustment will be applied where the patient balance will be reduced and the reduced amount will be pushed as insurance balance and the excess credits can be applied against this pushed insurance balance.


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Reversing MSB payments

In order to reverse the payments applied against an MSB code, one can navigate to the ledger and click on the MSB code which will open the code snapshot and the payments applied against the MSB code will be displayed. To reverse a payment, one can click on the X icon next to the payment line item and click on Proceed Anyway when an alert pops up indicating that you are about to reverse the payment. On reversing a Patient Payment applied against the MSB, the reversed amount will be pushed back as patient's unapplied credits. On reversing an Insurance Payment applied against the MSB, the reversed amount will be pushed back to the insurance receipt from which the payment was added.

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Written by Revati Krishnan | Last published at: August 08, 2021


What is Interest?


Interest is the payment from a borrower or deposit-taking financial institution to a lender or depositor of an amount above repayment of the principal sum (i.e. the amount borrowed). It is distinct from a fee which the borrower may pay the lender or some third party. The rate of interest is equal to the interest amount paid or received over a particular period divided by the principal sum borrowed or lent.

Compound interest means that interest is earned on prior interest in addition to the principal. Due to compounding, the total amount of debt grows exponentially. It is most often calculated on a daily, monthly, or yearly basis, and its impact is influenced greatly by its compounding rate.

Business Rules and Requirement


An interest would be applied to those patient accounts with code payments overdue for more than a specified number of days. Accounts which has a net balance due patient above a certain amount and are overdue for more than a specified number of days after checkout. The overdue amount and overdue period can be set in practice settings, along with interest rates and codes for interest application.

Interest would be compounded, i.e. interest is earned on prior interest in addition to the actual balance. Interest is first applied to a patient on the date mentioned in the settings. It is then reapplied on the same patient if applicable on the same date every subsequent month.

For example, if Interest is first applied on the code on March 5th, then it will be reapplied (provided the settings are not changed) on April 5th, May 5th and so on till the code is paid fully. If interest was first applied on January 31st, then it will be applied again on Feb 28th, March 31st, April 30th, May 31st and so on till it's paid. So, if 29, 30 or 31 is chosen, then for months without that date, the last date of the month would be used.

Some practices may also want to set a minimum amount during interest application, which could be set as a threshold and if the amount calculated using premium rates is lesser than that value, the interest amount set would get applied.

Setup


In Practice Settings > Payments > General > Billing Details, there would be a section to add Interest Details. It contains:

All fields are mandatory

Interest would be calculated on patient codes only after the user sets up the above-mentioned settings.

Process


Initially, all the basic settings in Practice Settings mentioned above would be set up only after which can Interest be applied to patient records. All codes of all patient records across the system with the balance due patient greater than zero would be inserted into a queue either at the end of the day or as and when the balance due patient value of a code becomes greater than zero. Removal of codes from this queue when its balance due patient becomes lesser than zero would also happen in a similar manner.

All patients belonging to accounts where the total unapplied credits equal or exceed the total balance would be ignored (Balance in the required aging bracket minus the current un-applied credits). For each patient, the Net Patient Balance in aging brackets exceeding the minimum number of days for interest generation would be used for interest generation.

The Net Patient Balance is the balance of the patient after reducing the current un-applied credits of that patient and interest would be generated only if that amount is still above the threshold amount.

Aging would be calculated using the transaction date of code completion - any adjustment or payment against the code will be tagged to the transaction date of code completion. Calculate the interest and generate the codes for each patient as per other criteria in practice settings.

For each patient, a code would be checked out (Interest code that was set up in Practice Settings) in that patient account (inside a treatment plan named Interest) with billing order N and patient payable value the interest value that was computed. The provider and location of the checked out code would be those mentioned in the practice setting.      


Written by Geo Thomas | Last published at: July 25, 2022


The close out option enables the practice to wrap up all the previous activities of the practice. This is used to ensure that no further changes are done to their records. The frequency and the date of closeout depends on the policy of the practice. 


In CareStack, this option is available under  System menu > Close out.


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Upon close out, the system goes into a locked state wherein updates/deletion to the following line items will be frozen


  1. Deletion of receipts: Deletion of patient, insurance and collection receipts whose payment date precedes close out date will not be possible.
  2. Backdated addition of receipts : Backdating payment receipts for a date preceding close out will not be possible.
  3. Payable modification : Payable modification for procedure codes which are checked out and whose date of service is before the closeout date will not be possible.
  4. Appointment details update : Modification of appointment details for appointments scheduled before close out date will not be possible.
  5. Checkout of procedure codes : Procedure codes cannot be checked out on dates preceding the close out date.
  6. Procedure code details update : Modification of procedure code details for codes which are checked out and whose date of service is preceding the close out date will not be possible.
  7. Deletion of checked out codes : Deletion of procedure codes checked out before the close out date will not be possible.


All these details are available in CareStack once the user enters the close out menu.


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If location level Close Out is enabled for the practice, the screen would appear as this.


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To initiate a close out, the details to be entered are New Close Out Date and Closing Remarks, which are mandatory fields.


There would be two options, Initiate Pre-Close Out and Finalize Close Out.


Upon clicking Initiate Pre-Close Out, a confirmation would be asked and after confirming, it would appear under the Finalize Close Out tab.


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There would be two options, Finalize and Reject.


Clicking Reject would terminate the close out process and it would appear in the Close Out Details tab as rejected.


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Now instead of Reject, if the Finalize option is selected, the process would be completed.


This would also appear in the Close Out Details tab, but with an option to Revoke it.


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This is also possible to finalize a close out by clicking Finalize Close Out under the Initiate Close Out section directly.


However, clicking Revoke would undo all the effects of the previous close out.


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Similarly it would always be possible to revoke the just previous close out by clicking the Revoke button next to it.


Permissions


The permissions related to close out comes under the General settings. 

Users would require separate permissions to ViewInitiateFinalize and Revoke a Close Out.


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Audit Trail entries


Any action related to Close Out would be logged in the Audit Trail.


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Written by Revati Krishnan | Last published at: October 03, 2022


А payment gateway is the technology that captures and transfers payment data from the paying entity to the acquirer and then transfers the payment acceptance or decline back to the payor. A payment gateway validates the customer’s card details securely, ensures the funds are available and eventually enables merchants to get paid. It acts as an interface between a merchant’s website and its acquirer. It encrypts sensitive credit card details, ensuring that information is passed securely from the customer to the acquiring bank, via the merchant. Here, CareStack is the merchant and the practice is the acquirer. The paying entity is either the patient or the insurance carrier.


CareStack supports two payment gateways,


Bluepay


Bluepay is a  provider of technology-enabled credit card payment processing services for enterprise, small and medium-sized businesses in the United States and Canada. Through physical POS(card processing machine), online and mobile interfaces, Bluepay processes payments and provides real-time settlement, reporting and reconciliation along with robust security features such as tokenization and point-to-point encryption. 

To be able to process card/check payments within the CareStack software & Patient Portal through Bluepay, the practice will need to create an account with Bluepay. This can be done by following the steps below.


Setting up a Bluepay account


The Bluepay account has to be set up by contacting Bluepay  https://www.clover.com/

The account credentials will be emailed to the practice once Bluepay contacts them to confirm the registration.

The account ID and the secret key can be found by following the steps below.

If no secret key is found, you can opt to generate one by clicking Create New Key

Once the account is created, the practice will need to contact Bluepay to enable the Bluepay JS module. This can be done by emailing the Bluepay Account ID to the Bluepay Integration Support team (integrationsupport@bluepay.com).

Setting up Bluepay inside CareStack at a Account level

Once the above prerequisites are accomplished, the following steps will need to be performed to start processing card/check payments within CareStack:

Navigate to System menu > Practice Settings > Payments > General > Payment Services

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In the Bluepay section, click Edit to enter the following details:

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Hit Save when you are finished. The Payment Gateway is now configured for processing online payments.

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In the Portal Payments section, hit Edit to enter the following details:

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Hit Save when you are finished. The Payment Gateway is now configured for processing online payments.

Setting up Bluepay inside CareStack at a Location level

For this, you would have to navigate to the Billing Service tab under Payments, select your location and click Edit.

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Once you set Use Account Settings as ‘No’, you would be asked to enter the Account ID and Secret key, if the Payment Gateway is set as Bluepay. The other fields are to be entered as per the interest of the practice and then hit Save.

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Payments using Bluepay

By default the payment screen would appear like this. Here, Robert Langdon is a test patient.

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Notice the changes when a payment amount is entered and the payment method is changed to Credit/Debit Card or Check. 

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Once you click on Pay with Bluepay, this payment screen would appear where the card details have to be entered.

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Clicking Make Payment would process the payment, and a receipt would be created. All transactions done through Bluepay would be visible under System menu > Bluepay transactions

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Here, next to each payment, there would be an option to void the transaction. Clicking this would delete the receipt and refund the amount back to its source. 

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This could be done from the All Payments tab under Billing > Payments in the patient account as well.

Editing a payment

Unlike other payment methods, transactions done through Bluepay are not fully editable. The user would only be able to edit the Payment type, Location, Payment date, etc by clicking more info from the receipt.

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Unprocessed payments

In some cases, the Bluepay transaction would have been initiated, but the payment would not have been processed. The amount would have been debited from the patient’s account, but the practice would not have received the payment. Though the real cause of this issue is unknown, this issue could be resolved by navigating to System menu > Bluepay transactionsThe transaction would appear here as in the image below.

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In such cases, clicking Process Payment would complete the transaction.

Refunding a payment


As mentioned before, a payment could be refunded by voiding the transaction. But in cases where a payment is to be refunded partially, the user would have to login to the Bluepay portal. 

Required Permissions


The following are the permissions required to carry out Bluepay transactions.


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The following permissions are required to carryout bluepay related operations from the bluepay transactions list.


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Apex Payments


Apex is a payment gateway similar to Bluepay. 

Setting up an Apex account

To set up an account and to use their services, the practice would have to contact Apex Payment Solutions. https://www.emcrey.com/

Setting up Apex inside CareStack(Account level)

The following steps will need to be performed to start processing card/check payments within CareStack:

 Navigate to System menu > Practice Settings > Payments > General > Payment Services

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There, in the Apex Payments section, click edit.

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This is where you would have to set Enable Apex Payments as Yes, which would ask you to enter the Merchant ID and the other details.

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The user would have to enter the secret key by clicking the Set key.

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After this, clicking Save would complete the integration process.

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Setting up Apex inside CareStack (Location level)

To set up Apex payment at the location level, the user would have to navigate to the Billing services tab under payments and select a location, and then move on to the Apex payments tab in the pop-up that appears.

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Here, once you click edit, you would have the option to choose account level settings or location level settings. Some practices prefer to use location level settings, which would let them enable this feature only for certain locations.  However, a device has to be set up to capture the payments.


This can be done by clicking Add Terminal DeviceThe user would have to enter the details of the device and click save.


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Payments using Apex


As mentioned before, the payments screen appears like this by default.


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Now if the payment type is selected as CREDIT/DEBIT Card, the option Pay with Apex would appear.


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Once the user clicks this button, there would be two options, Pay with Terminal and Card Not PresentThe machine that can be used to capture card payments would have an application named AnyPay Cloud. Once the user opens this application, a screen would pop up on the device, waiting for transactions. 


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Now, clicking the Pay with Terminal option in CareStack would show the payment amount on the device screen, letting the patient swipe the card  and complete the payment. Apex also provides an option to pay without swiping the card. For this, the user would have to select the Card Not Present option. 


This would open a payment screen similar to that of Bluepay, where the payment amount and the patient name would have been auto-populated. The patient would have to enter the details like card number, cvv, expiry date, etc


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Either way, a receipt would be created after the completion of a successful transaction.


Refunding a payment


Unlike Bluepay, it is not possible to refund an Apex payment from CareStack. Deleting the receipt would only remove the record of the payment from CareStack. To initiate a refund, the user would have to login to their Apex payment portal and then initiate the refund from there. 


Required Permissions


The permissions required to add/process apex payments is same as that of Bluepay.


FAQs

  1. I added a payment using Bluepay but no receipt was created. The amount was debited from the patient. Where can I find the receipt?
    • The payment would have been initiated, but might not have been processed. The payment would be visible under System Menu> Bluepay transactions. Clicking 'process payment' would complete the transaction.
  2. How do I initiate a partial refund?
    • Partial refunds can be initiated only from the payment gateway's portal.
 


Written by Revati Krishnan | Last published at: July 31, 2021


It's time to look at the payments that patients make on their accounts. The first thing you probably think of when we talk of patient payments is the payment itself. The amount, the type, and so forth. 

You are correct! 

Those payment details are entered into CareStack and kept as a receipt record. But there is more to it. The payment needs to be assigned to the different charges in the account, so we always know when and how a charge was paid for. 


Patient Payment Slider


You can kick off the patient payment process from a variety of different locations, including the profile, search results, ledger, or the appointment.

From Search: You can quickly leap to the payment slider by clicking the Payment link in the grey quick link bar. 

BE CAREFUL!! The slider opens on top of your current task. When you are finished, you will return to the task and patient you were working on before.

From the Patient Profile: Click the Billing icon in the Patient Navigation Bar and select Payment.

From the Patient Menu: Click the Menu icon in the Patient Navigation Bar and select Add Payment


You'll also find links to the payment screen elsewhere in the profile, like the appointment and the ledger.

Once you are there, you'll find a great deal of information about the patients in the account, balances, charges, and credits organized into tabs: 


Add a Payment Receipt


Remember that patient payments have two components: 


The patient payment slider builds these components into the window. Since the first element is the payment itself, you’ll begin by capturing its details: 


Enter the payment details.


Add Payment to Charges


Now we are ready to deal with the important second step, applying the payment to the patient portion of the outstanding treatment codes. 


Show all your codes, even those without balances, with the Include Codes without Patient Dues checkbox.


By default, CareStack will apply the Payment Amount to the charges from oldest to newest. That's easy because it is often exactly what you want. 


You can also change the allocation to newest to oldest with the dropdown at the bottom of the screen


Apply to Specific Patients or Codes


Watch Carefully! If you change the charges the payment should apply to, the Payment Amount will change


Advanced Payments & Unapplied Credits


Unapplied credits are funds that are held on behalf of a patient that have not been applied against any charges. It is credits which are available in the patient’s account and have not been applied against any charges. When the practice takes advance payments they just won't have to apply the funds to the charges right away. Instead, the funds are held as Unapplied Credits. The patient's account will show this credit balance until the credits are applied. There are many scenarios which may lead to the unapplied credits being added to the patient’s account such as :



Accept an Advance Payment

Taking an advance payment is similar to taking a regular payment; you just won't have to apply the funds to the charges right away. 

Instead, the funds are held as Unapplied Credits. Your patient's account will show this credit balance until the credits are applied. As with traditional payments, start at the Add Payment slider. 

To accept an advance payment:


Allocating Unapplied Credits

Unapplied Credits will appear in an account when a payment, transfer, or adjustment has been added but not applied against a charge. You can apply the credits directly on the Add Payment slider.

To apply credits:

Written by Revati Krishnan | Last published at: August 22, 2021



Refunds


Consider a scenario when the patients have credits and they don’t owe anything, they might want to hold the credit to apply to future treatments, or, they might want the money back. This is where ‘Refunds’ have a role to play - when the patient wants their money back.

Refunding of credits means for the dental practice to return unallocated credits back to the source from which it was received. Refunding of credits can be done from either a patient receipt or an insurance receipt which has some amount of unallocated credits in them. 

During refunds, the user would be able to select one or more of these credit sources and then proceed to create a refund for the patient / insurance.   

In order to do a patient refund, the user should :


Making a Patient Refund


Refunding from a patient receipt can be done either to the patient for whom the receipt was added or to an insurance carrier. Every patient refund is associated with the following :

Refund To: A radio button option with labels -  Patient (Default) and Insurance


The user has two options- Refund and Refund and Print and there is also a checkbox called Print Refund Check.

Print Refund check helps the user to print the refund check directly from CareStack (The user must have the specialty paper to print them). Refund button is used to apply/initiate the refund. Refund and Print button is to print a receipt about the refund while the checkbox prints the literal check.

On refunding, if the Amount entered is less than the total unapplied credits in the selected receipts, the credits should be refunded from the receipts in the FIFO order of receipt creation.

If the amount is greater than the total unapplied credits in the selected receipts, an inline warning must be shown blocking the user from proceeding with it. (Warning: "Refund amount should be less than or equal to the total unapplied credits in the selected receipts")

After the refund, the unapplied credits against each receipt should be changed automatically to reflect the actual remaining credits without the user having to refresh the page.


Permission Required

The following permission needs to be set to yes in order to perform the action :

Refunds/Adjust Off Patient Payments


Example Scenario



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In the above scenario, the patient has an unapplied of $373. 


After refunding $60, this will be reflected in the ledger as shown below:


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After refunding the amount, the unapplied is reduced by $60. Now the unapplied is $313.

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Refund Reversal


The amount that has been refunded from a receipt can always be reversed and reversing the amount would push the amount back to the receipt.  

In order to do this, you can navigate to the patient ledger and click on the More info next to the receipt. This will open the payment details pop up for that receipt. Now click on Refunds where you will be able to see the amounts that have been refunded from the receipt. Now select the Refund amount which you want to reverse and click on Reverse Refund. This will push the amount back to the receipt.

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This will push back the amount to the receipt and the unapplied credits for the patient will be $373 again.

You can also see the refund activities in the history tab of the receipt.

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Permission Required

The following permission needs to be set to yes in order to perform the action :

Reverse Refunds/Adjust Off Patient Payments



Written by Revati Krishnan | Last published at: August 22, 2021


When there are excess credits in a patient receipt and if those credits are not to be refunded, but would need to remove them in order to clear the books at the end of a month or so, the Adjust off Credits functionality can be used.

You can always write-off or adjust off the entire unapplied credits or a portion of the unapplied credits from a receipt using the adjust off unapplied credits feature. 

In order to do this, please navigate to the Refund/Adjust Off tab from the Patient overview > Billing > Payments > Refund/Adjust Off.

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Here, you would have to select the receipt from which you want to write-off the unapplied credits and in the right side of the window, you can choose the amount you would like to adjust off, enter the remarks and click on Adjust Off.


This section would contain two fields:

There would be an Adjust-Off button which would be enabled only if the Amount is greater than $0.00. Clicking Adjust-Off would reduce the unapplied credits in the receipt with the Amount mentioned.  If the Amount entered is less than the total unapplied credits in the selected receipts, the credits would be adjusted off from the receipts in the FIFO order of receipt creation. If the amount is greater than the total unapplied credits in the selected receipts, an inline warning would be shown blocking the user from proceeding with it. (Warning: "Adjust-off amount would be less than or equal to the total unapplied credits in the selected receipts").

After the adjust-off, the unapplied credits against each receipt would be changed automatically to reflect the actual remaining credits without the user having to refresh the page.

Entries for adjust off for each receipt would be there in the ledger and its print, system transaction and its print, walkout report, statements, payment summary, receipt's payment details modal (Adjust-Off tab & Receipt History tab) and also in several Operational Reports like Payment Log report. 

Example Scenario

Taking the above scenario, to write off $20 from the $50 receipt, you can choose the $50 receipt and enter the adjust-off amount as $20 and click on Adjust-Off.

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These adjustments will now reflect in the patient’s ledger and an adjust-off adjustment  will be shown along with the payment receipt.


This would be how the ledger of the above patient will come up after the adjustment has been made.

Related image: ./carestack-questions-2023-03-02_files/1628002283484-1628002283484.png 

On clicking the receipt row, the adjust off applied against that receipt would be highlighted. Here, you can also see that the unapplied credit balance of the patient now stands at $30 which was $50 before adjusting off $20. You can also hover over the note icon on the adjust off row to view the remarks that you had for the adjustment.


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You will only be able to adjust off the unapplied credits that are left in the receipt. So the adjust off amount should be equal to or less than the unapplied credits left in the receipt. If the adjustment amount is greater than the unapplied credit that is left, the following error toaster will be displayed as shown in the screenshot below.

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Here the error is encountered because the receipt only has an unapplied credit amounting to $6 left ; whereas you are trying to adjust off $9 from the receipt.


Reverse Adjusted Off Entries

The amount that has been adjusted off from a receipt can always be reversed and reversing the amount would push the amount back to the receipt. 

In order to do this, you can navigate to the patient ledger and click on the More info next to the receipt. This will open the payment details pop up for that receipt. Now click on Adjust Off where you will be able to see the amounts that have been adjusted off from the receipt. Now select the adjustment amount which you want to reverse and click on Reverse Adj-Off. This will push the amount back to the receipt.

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After reversing the adjustment and refreshing the ledger, the adjustment of $20 which was shown along with the payment receipt will be removed from the ledgePerm


Permissions needed

 A user would need to have the necessary permissions assigned to his/her profile in order to perform the refund and reverse refund actions. 

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Written by Revati Krishnan | Last published at: August 22, 2021


You might now know how to post a patient payment. Mistakes might happen while posting a patient's payment. This will force the user to get rid of the incorrect payment that has been posted. In such instances, CareStack helps its users to delete a payment receipt that would eventually reverse the patient's payment.

Workflow to Delete a Patient Receipt

In order to delete a patient payment, it is necessary that a user has the required permissions. To check the permissions navigate to the System Menu > Practice settings > Administration > Profiles > Look for your profile > Click on Manage permissions

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  1. All patient payments posted using the receipt will be reversed.
  2. All refunds and adjust-offs made using the receipt will be reversed.
  3. Transaction charges and their associated write-off adjustments will be reversed

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Example Scenario

Consider the patient Rinu Jac, for whom payment receipt # 249688 has been deleted. The amount the patient paid was $2000 and the unapplied credits were $1028.09. The deletion of this receipt would reverse this payment, which would make the Total Bal. Due Pat. the amount the patient has to pay and the unapplied credits become zero again.

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Do watch this video for reference. 


Now you are all set to delete an insurance payment. Give it a try!


Written by Abhishek Vijay | Last published at: August 25, 2022


Quite possibly the heart of the Revenue Cycle Management module of CareStack, the Ledger.

The ledger records the summarized financial information of the patient and their account members as debits & credits as well as displays their current balances.

The ledger is a reflection of all the financial transactions initiated and completed by the user, something like a footprint. A feature like this enables the user to have a real-time look at the financials of the patient.

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In CareStack, while navigating to Patient > Billing > Ledger, there would be two sub-tabs; Patient Ledger, and Account Ledger.
Related image: ./carestack-questions-2023-03-02_files/1627746456310-2.gifThe patient ledger lists out the details concerning the patient profile, while the Account Ledger lists out the transactional history of the Account members as a whole.

There would be three grids in either tab to show the various details of transactions done for the patient, the Summary Grid, the Aging Grid, and the Transactions Grid.


Aging Grid


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This grid would show the aged patient and insurance balance of the codes of the patient and the account members, grouped into different aging buckets:

There would also be a column to show the individual balance totals as well as the combined balance total. 

If balance > 0, then it would be shown in red color.
  

The aging summary would be visible above the itemized transaction grid in both the Patient and Account Ledger tabs.


This would show the aged patient as well as the insurance balances of all the account members in both tabs.



Summary Grid


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The Summary Grid in the Patient tab would show the summarized view of the financial status at a patient level and an account level.

It would consolidate the data for all members of the account, irrespective of the ledger tab. 

The grid at all times must have the following columns:

Irrespective of it being the Patient Ledger or Account Ledger, 
  

If balance > 0, then it would be shown in red color

&

All the applied payments must be green.


Transactions Grid


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This grid would show the itemized list of all transactions done in the latest last order, as default, but can be sorted. The Transactions Grid ideally has the following columns:

The patient ledger and account ledger grids have a column that displays a running total representing the balance up to that transaction. It represents the balance after that transaction was posted.
  
There would also be a Total row that would show the totals of UCR, Max Allowed, Ins. Amt. and Pat. Amt. fields.
  
Now that we have an idea about the framework of a typical ledger page, let’s have a look at the constituent elements inside.

Completed Codes


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An entry would appear in the ledger when a code is marked as completed. 

The entry description would be Date, Code, Procedure Code Description, followed by the DOS. The date in the corresponding entry is the transaction date on which a code was completed. The tooth/area, surface and provider associated with the completed code is populated. The code is clickable, showing the associated code snapshot when clicked.
  

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The UCR fee from the respective fee schedule is shown, and $0.00 is populated if a UCR fee cannot be obtained. The Max Allowed fee is set as the sum of Insurance and Patient estimates.
  
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The entry must have positive values in both of the Ins. Amt and Pat. Amt columns signifying an increase in the balance dues

If the fee or other details of the completed code is updated, the changes are to be made on the same entry itself by overwriting the old details with the updated values.

If the code is deleted, then the entry for the newly added code must also be removed. When an entry for code addition is clicked, the code's payment allocation modal is:

  
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If any notes have been linked to the code, then it must be shown when clicked upon a notes icon beside the code.


Entries for code addition must appear in a similar manner in the ledger print as well.
  

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When a code is completed as a result of an ortho payment plan termination the description is:
  

Patient ortho payment plan terminated - Completed <Procedure_ID> - <proc_desc> (DOS: <termination date>)


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If an insurance ortho payment plan is terminated:


Insurance ortho payment plan terminated - Completed <Procedure_ID> - <proc_desc> (DOS: <termination date>)
  

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Payments


An entry would appear in the ledger whenever a payment is credited or posted on a patient account from either patient, insurance or a collection receipt.

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The descriptions for each of the entries is as follows:

Receipt #xxxxxx would be the receipt ID of the associated receipt from which the payment was posted. For transferred receipt, the patient receipt #xxxxx of the newly created receipt is shown. This is a link, clicking on which would open up a snapshot which contains the following details about the receipt:


Adjustments


An entry would appear in the ledger whenever an adjustment is posted on a completed code of a patient from either patient, insurance or a collection agency payment posting context.

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The descriptions for each of the entries is as follows:

Adjustment Code & Description is the code using which the respective adjustment was made. The code is a link, clicking on which would open up a snapshot which contains the following details about the adjustment code.


Refunds


Patient Refunds

An entry would appear in it only when refunds are made from patient/account members receipts. The entry description is:

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If refunded to patient : 

'Refunded $xx.xx to patient from Rcpt #xxxxx by <Payment Category - Payment Type> at <Refund Location Short Name> (Refund Date: <MM/DD/YYYY>)”.

If refunded to insurance : 

'Refunded $xx.xx to <carrier name> from Rcpt #xxxxx by <Payment Category - Payment Type> at <Refund Location Short Name> (Refund Date: <MM/DD/YYYY>)”.

Insurance Refunds

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An entry would appear in it only when refunds are made from insurance receipts and tagged to the patient/account member or their claim.

The entry description is : 

'Refunded $xx.xx to <carrier name> from Rcpt #xxxxx by <Payment Category - Payment Type> at <Refund Location Short Name> (Refund Date: <MM/DD/YYYY>)”.


Claims & Authorizations


Claims

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An entry would appear in it only when a Claim is submitted (Submitted (Payor)/Ready to Send Status). 

The entry description is:  '<Claim Order> Claim #xxxxx created for <carrier name> - <current Claim status>'.


Pre-Authorization

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An entry would appear in it only when an Authorization is sent (Pending/Ready to Send Status).

The entry description is: 'Authorization #xxxxx created for <carrier name> - <current Auth status>'


Statements


When a statement has been generated for a patient, there is an entry in the corresponding patient ledger with the net balance due mentioned in it.

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In the account ledger, there are entries for each patient for whom the statement was sent along with their respective balances dues.

The entry description is: 
Statement created for $xx.xx - <Current statement status>

Filters



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Date Filter: A custom date filter must be available on top allowing users to filter and view records during that time slot.

Type Filter: Must include an entry for each action shown in the ledger, allowing users to filter using those. It is a multi-select filter with None selected by default. None selected and all selected would have the same functionality of listing all kinds of entries. The entries is in the following order:


Print


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There is a print icon in both sub tabs which when clicked will print the ledger as it is being viewed on the screen at the moment the print icon was clicked with all filters applied.


All three grids are printed as such.




Written by Revati Krishnan | Last published at: August 22, 2021


Some of the third-party financiers may charge a small fee for the processing and handling of charges. CareStack allows you to track these fees and manage them as your process payments using special payment types. 

In this article, we’ll look at :


Initial Setup


Setup a Payment Type

The first step in tracking these transaction charges is to create a payment type that identifies the fee. To add a Payment Type go to Practice Settings > Payments > General > Payment Types tab. 


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Default Adjustment Code for Posting Transaction Charges 

CareStack already includes a system level adjustment code called TRNCH for Transaction Charges that will reduce the patient portion by the amount of the charge when applied.


Process a Payment


Process a payment with a transaction charge the same way you process any other payment, just use your Care Credit payment type. CareStack will calculate the amount of the fee to include as an adjustment type. 

The transaction fee will be deducted from the amount of the patient payment so that the net is applied to the patient balance. That fee will then be adjusted off from the patient with an adjustment. To process a care credit payment with a transaction fee: 


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CareStack will calculate the transaction charge based on the payment type setup and the payment amount. 


                                                     

                                             Related image: ./carestack-questions-2023-03-02_files/1628014873356-1628014873356.png

 
CareStack will add the TRNCH adjustment code to the codes and apply the adjustment amount in your selected application order (oldest to newest or newest to oldest).

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Depending on your codes and amounts, not all codes may have an adjustment applied. You can manually change the code the charge adjustment is applied to or the split of the adjustment code. 


The payment and discount will be applied to the patient account. Your patient will see that they were reimbursed the transaction charge and yet your practice will be able to fully track the charge.


Impact in Ledger

There will be three entries in the Ledger : 


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Impact in Statements 

In Menu > Statements, under the Minimum Account Balance to Generate section, there should be an option "Exclude Unadjusted Transaction Charges" which would by default reflect the value which is set in Practice Setting > Payments > General > Statements "Exclude Unadjusted Transaction Charges from Net Account Balance".

If this option is set to No, while considering the minimum balance to generate, it should also subtract the unadjusted transaction charges of all the considered patients from the net balance.

If it is Yes, then all balances should be considered how it is now.






Written by Revati Krishnan | Last published at: August 22, 2021


Naturally, you enjoy caring for people and providing treatment, but it is important to get paid. Patients are much more likely to pay when you give them many different ways to do so. CareStack is on the forefront of contactless care and is now offering Text to Pay. In this way, you can text your patients asking them to pay, and they can pay directly from their phones with a link in the message.


Steps to enable Text to Pay


There are some Practice Settings you'll need to select before you can use Text to Pay at your practice. That's probably been done, but it is worth a check. Practice Settings > Payments > General > Others > Portal Payments


If your practice chooses to use location level settings for portal payments you may enable the under Practice settings > Payments > Billing Services, where you may click on the location, select the Portal Payments tab and select Use Account Setting as ‘No’ and then enter the locations Account ID and Secret Key.


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Send a Text to Pay Message


CareStack has made it easy for you to send the Text to Pay message to your patients. A Text to Pay button is available on the Home Dashboard while scheduling an appointment when you right-click on the appointment block and the Ledger.

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To send the message:

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Related image: ./carestack-questions-2023-03-02_files/1628014735087-1628014735087.png

Your patient will receive a text with everything they need to pay the balance amount. Nothing to download, the patient just clicks the link and follows the easy instructions.

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Once the patient clicks on the link they will be redirected to the secure Bluepay transactions window.



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Here they can click on Proceed to Payment which allows them to enter the card details to make the payment.




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The user can enter their card details and click Make Payment to submit the payment.


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Once the payment is successful the user will be to get an invoice at the mentioned email address. If the payment fails they can restart the payment by clicking on the Go to home button.




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To receive the invoice the patient can enter the email ID at space provided. The Invoice will be sent to the patients email ID.


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You’ll always be able to find the history of the text messages in your Patient Text module.


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Working with Payments


The patient has made the payment by text. Now what? It depends on your practice's settings. 


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Your practice can choose to handle the payments in a few different ways: 



The order to apply credits can also be chosen, using the option, Automatically Post Credits against Balance in option which is populated if the previous option is set to any other option but the one to leave the payments as unapplied credits. 


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Viewing Payments 


However your practice handles those payments, you'll be able to see the details of the payment and how it was applied on the Receipt Details. Payments added via Text to Pay has payment method set as Payment Portal. Access it from the Payment Slider or from the Ledger:Related image: ./carestack-questions-2023-03-02_files/1628016412791-1628016412791.png

Tracking down Payments 


The Text to Pay message heads off through cyberspace to the patient.  Even though it is incredibly easy to pay using the text, the patient might not do it immediately. They might do it in an hour. They might do it in six hours, or six days. All reports showing patient collection will show payments made through ‘Text to Pay’. Find Insights under your System Menu to generate the reports.

Written by Revati Krishnan | Last published at: August 22, 2021


A walkout report shows a summary of the treatments and payments which includes the balances, charges, and credits that the patient has. It also shows the details of the upcoming appointments.

Permissions


To Print the report, the user Profile needs the required Permission. The Permission to Print the Walkout report is set from Administration > Profiles > Patient > Transaction Log > Set that to Yes.

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How to obtain a walkout report?


A walkout report can be printed by clicking on the Print quick link on the top. Now choose the time frame and check the box for the walkout report. On clicking Print, the report opens on a new tab.  

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The top left portion of the Walkout report shows the patient details like the Patient name, Patient ID, and the Responsible party. The printed date and selected time frame will be also shown here.

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The location on the Walkout report(on the top right) is the user location from where the report has been initiated. The location is pulled up from Practice settings > Locations > Print settings.

If the branding is set on account level:


If the branding is set on location level:


The Walkout report has three grids:

The first grid gives the consolidated view of the system transactions in the defined time frame. The first entry in the grid would always be the Previous Balance which is the total due as of the previous day of the time frame chosen. For instance, if the time frame chosen is from 01/27/2020 to 01/30/2020, then the Previous Balance should display the total Patient Balance as of 01/26/2020. The columns in this grid are as follows:

The entry descriptions for the different entries are given below.

Actions 

Entry descriptions 

Procedure checked out 

Procedure code-Completed with DOS 

 
Eg: Completed Retreat RCT/Bicuspid with DOS 01/26/2021 

Updated payable amount from the EOB/manually 

The updated receivable amount for the code with DOS 

 
Eg: Updated receivable amount for the code with DOS 01/26/2021 

Insurance transfer to patient 

 
 

Transferred amount from ins. receipt # of carrier <carrier name> to pat. Receipt # of patient <patient name>(patient ID) 

 
 

Eg: Transferred $80.00 from Ins.Rcpt. #249510 of carrier AMERITAS LIFE INSURANCE CORP. to Pat.Rcpt. #249511 of patient Mr. Rudan, Carl (10031296)  

Patient payment by any payment type 

Receipt #xxxxxx - Pat. payment credited by <Payment category> payment type>  

 
 

Eg: Rcpt. # 249311 - Pat. payment credited by CASH - Cash  

The patient payment was applied from a receipt 

Pat. Payment of $xx was applied from patient Rcpt. #xxxxx of <patient name> (patient id) 

 
 

Eg: Pat. Payment of $1026.00 was applied from patient Rcpt. #249311 of Mr. Rudan, Carl (10031296) 

Adjustment against Patient component 

<Procedure code> - Adjusted $xx.xx for patient against <adj_desc> 

 
 

Eg: D0120 - Adjusted $0.03 for patient against STAX / Sales Tax 

Insurance payment applied from receipt 

Ins. payment of $xx.xx was applied from carrier <carrier name> Rcpt. #xxxxxx 

 
 

Eg: Ins. payment of $38.00 was applied from carrier AMERITAS LIFE INSURANCE CORP. Rcpt. #249324  

Adjustment against Insurance component 

 
 

<Procedure code> - Adjusted $xx.xx for insurance against <adj_desc> 

 
 

Eg: D0120 - Adjusted $42.03 for insurance against AC003 / ADJ OFF 

Collection payment is applied from receipt 

Col. Payment of $xx.xx applied from <collection agency name> Rcpt. #xxxxxxx 

 
 

Eg: Col. payment of $20.00 was applied From col. Agency First Federal Credit Control(FFCC) Rcpt. #249678 

Patient refund by any payment type 

Refund: Rcpt. #xxxxxxx $xx.xx by <Payment Category -Payment Type> 

 
 

Eg: Refund: Rcpt. #2342156 $25.62 by CASH 

Patient refund to insurance by any payment type 

 
 

Refunded $xx.xx from Rcpt. #xxxxxx by CASH - Cash at <Location> (Refund Date:xx/xx/xx) 

 
 

Eg: Refunded $200.00 from Rcpt. #249404 by CASH - Cash at MALL (Refund Date:07/22/2021 

Patient ortho payment plan terminated 

Patient ortho payment plan terminated - <Procedure code> - <code description> with DOS xx/xx/xxxx  

 
 

Eg: Patient ortho payment plan terminated - D8010 - Completed Limited Primary Dentition with DOS 07/21/2021  

Insurance ortho payment plan terminated 

 
 

Insurance ortho payment plan terminated - <Procedure code> - <code description>with DOS xx/xx/xxxx 

 
 

Eg: Insurance ortho payment plan terminated - D8010 - Completed Limited Primary Dentition with DOS 07/21/2021  

Receipt labelled as a non sufficient fund check 

 
 

Rcpt. #xxxxxxxx - has been marked as a non sufficient fund 

check 

 
 

Eg: Rcpt. #291766 - has been marked as a non sufficient fund check  

Non sufficient fund label removed from a receipt 

 
 

Rcpt. #xxxxxxxx - NSF label has been removed from the check 

 
 

Rcpt. #291766 - NSF label has been removed from the check 

Transfer from Patient to Insurance 

<Procedure code> <adj_amt> transferred from patient to insurance against <Adj code> <Adj_desc> 

Transfer from Insurance to Patient 

<Procedure code> <adj_amt> transferred from insurance to patient against <Adj code> <Adj_desc> 

Receipt amount adjusted 

Adjusted off $xx.xx from Rcpt. #xxxxxxx. 

 
 

Eg: Adjusted off $367.50 from Rcpt. #249386 


The second grid shows both the patient and insurance balance aging summary as on the end date of the time frame we are using. It shows the outstanding balance owed by the insurance or patient within the time frame(0-30,30-60, …). 


Now the third grid gives the details of the future appointments that are scheduled from the end date of the time frame that is used to generate the report. It has the following columns:


The future appointments shown in the walkout report should be based on the time zone of the location of that appointment. For example, an appointment in Mallory at 12 pm should be shown as a future appointment till it is currently 12 pm in Mallory.



Written by Revati Krishnan | Last published at: August 22, 2021


In CareStack, it is possible to post payments in a batch, that is to post the unapplied credits against the balances for multiple patients at once. You would have to tell CareStack which credits are to be posted and how to post them, and CareStack will take care of everything all at once. 


Workflow

This could be done by navigating to the System menu >  Patient Payments >  Batch Posting tab. Only users with the respective permission from Practice Settings > Administration > Profiles > Manage Permissions > Billing > Patient Payments > Batch Post of Unapplied Credits. would be able to to View and Perform all actions in the Batch Posting tab.


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In the Batch Posting tab, you will see a list of all the batches that have been posted at your practice(if any) with the summary details. When this is chosen, there would be a grid with the following columns:


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This grid would be paginated with 15 entries and would be sorted in the latest first order.

On this page, there would be an action button on the header, Post Unapplied CreditsThis when clicked would open up a pop-up.

This popup would be divided into two sections.

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There would be a Cancel and Apply Credits button as well. 

Cancel would abort the process and close the modal (similar to the cross button on the modal header) and Apply Credits would apply credits to all applicable balances. When Apply Credits is clicked, all payments that satisfy the above criteria would be considered and payments would be posted against the respective patient/account balances in the oldest/newest first order.

This payment application would be run as a background job and wouldn't hinder with the user's workflow. When Apply Credits is clicked, the pop-up would be closed and an orange toaster "Apply Credits functionality initiated" would be shown indicating that the process has started. Similarly when the posting is completed, a green success toaster indicating the completion of the process "Credits applied successfully" would be shown to the user irrespective of the page the user is currently in.

The Post Unapplied Credits button would be disabled as long as one is being processed so that users wouldn't initiate multiple requests at the same time. This button would be usable only if at least one payment has been added for any of the allowed locations of the user. The button would be disabled. 

In case, no receipts are available to be posted, the completion toaster would be in blue color and would say, "No payments to be posted", indicating that there are no payments matching the criteria that have unapplied credits to be posted.

This would take a few minutes and the screen would appear as in the image below.


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Once the posting is complete, its summary would appear as in this image.


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Clicking on the Show Filtered Result would automatically navigate to the Patient Payments tab and show the details of the posted payments.


When the Exceptions link is clicked, it would allow users to download a report as in the attached link. It would have the following details:

It would have all the batch details specified when the batch was initiated. There would also be information pertaining to when the report was printed as well.

It would also have the following details:

This would show only one patient once even if two payments associated with the same patient failed to post.

All details shown on this report would be based on the financial details of the patient as of the day on which the report is being printed.

Written by Revati Krishnan | Last published at: August 22, 2021


Instead of logging into BluePay to void a Patient payment or to view the status of a payment, an exclusive tab has been provided to monitor and perform action on BluePay Payments. When a payment is made on CareStack through BluePay , the transaction is shown in the BluePay transactions. The BluePay transactions tab in CareStack shows only the transactions up to the last 7 days. 

Voiding a BluePay payment will reverse the BluePay transaction and the voided amount will be credited back to the patient’s bank account.

The payment receipt will also be deleted from the patient’s ledger and any postings or adjustments made against the receipt will be reversed as well. You can void a BluePay transaction by clicking on the Void button in BluePay transactions.


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On clicking the Void button, a warning message will appear which will remind the user the impact that the void action would bring about. The user can also enter any remarks and click on Delete when it is done.

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Once the transaction is voided, the status of the transaction will change to Void and the Void button will no longer be displayed under the Actions column.

Attached below is the screenshot of the transaction after it has been voided. (Before; the status of the transaction was Approved and the Void button could be seen under the Actions column)

Related image: ./carestack-questions-2023-03-02_files/1628005266456-1628005266456.png 

The receipt will also be deleted from the patient ledger once the transaction has been voided.


Permissions Required

A user will need to have the necessary permissions to view and void BluePay transactions list.

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Written by Revati Krishnan | Last published at: August 01, 2021


A system transaction is a record of all RCM activity associated with a patient or account. This page would keep track of every action made during the life cycle of a procedure code. This may be observed by selecting a Patient and then going to the Archives and clicking on the System Transaction sub-tab. When a user accesses a system transaction, they are directed to the last page of the transaction with the latest entry in view. There would be a maximum of 30 entries per page and only a page level scroll would be required. 

The System Transactions tab can be viewed from Patient > Billing and the option would only for users with View Transactions Logs permission.

There are 2 sub-tabs on the landing page — one for Patient Transactions and the other for Account Transactions.

Both these sub-tabs have a common grid with columns as stated below:

There is also be a column to display the Patient/Account unapplied credits based on the current sub tab.

Patient Transactions sub-tab — all transactions due to payments made for this patient. A grid with the columns of the grid as stated below is displayed:

Account Transactions sub-tab — all transactions due to payments made for this patient's account members. A grid with the columns of the grid as stated below is displayed:

There should also be a Total row at the end, which would sum up the Pat. Amt, Ins. Amt. and Credits columns in each page.

Entries would appear in the system transaction whenever one of the following transactions are done:

Adjustment Action Entry in System Transaction
Add to Patient  When an adjustment with this action is posted, a positive entry with an amount equivalent to the amount adjusted must be made in Pat. Amt. Column
Add to Insurance When an adjustment with this action is posted, a positive entry with an amount equivalent to the amount adjusted must be made in Ins. Amt. Column
Deduct from Patient When an adjustment with this action is posted, a negative entry with an amount equivalent to the amount adjusted must be made in Pat. Amt. Column
Deduct from Insurance When an adjustment with this action is posted, a negative entry with an amount equivalent to the amount adjusted must be made in Ins. Amt. Column
Transfer to Patient  When an adjustment with this action is posted, a positive entry with an amount equivalent to the amount adjusted must be made in Pat. Amt. Column and a negative entry with the same amount must be made in the Ins. Amt column.
Transfer to Insurance When an adjustment with this action is posted, a positive entry with an amount equivalent to the amount adjusted must be made in Ins. Amt. Column and a negative entry with the same amount must be made in the Pat. Amt column.

Consolidated View & Legend

There is an option to switch between a consolidated view and an expanded view in the system transactions. This is implemented by including a checkbox labeled Consolidated View at the top right. If this checkbox is selected, only the final updated payable values against a code would be shown, by consolidating all the reversals that had happened in between. If this is not selected, show the full list of transactions involved with all the historical reversals would be shown properly. Consolidated view also will not include any payment or adjustment reversals as well. This checkbox would be unchecked by default when the system transaction page loads first and when a user switches from the Account Transactions tab to the Patient Transactions the checkbox selection state is retained.

For example, if an amount of $50 is posted against a procedure code for a patient and it is later changed to $30:

If in the consolidated view, the system transaction should include only the final entry of $30 posted against the procedure code. The description of the original entry should be retained, and the values would be the updated values.

If not consolidated, the system transaction should include all the associated entries such as $50 posted against the procedure code, reversal and the changed amount of $30 posted against the procedure code.

There is also a Legend (info icon on the top right corner), which would list all possible transaction code that could be shown in the system transaction along with its corresponding action.

System Transaction Entry Description 

Trans. Code 

Action 

Entry Description 

Pat. Amt. 

Ins. Amt. 

Credits 

PROC-D 

Procedure checked out 

<Procedure_ID> - Completed <proc_desc> with DOS <Date of Service> 

Positive Entry 

Positive Entry 

Zero 

PROC-RP 

Procedure code deletion 

<Procedure_ID> - Deleted <proc_desc> with DOS <Date of Service> 

Negative Entry 

Negative Entry 

Zero 

PROC-UR 

Updated Payable amount from EOB / manually 

<Procedure_ID> - Updated receivable amount for the code with DOS <Date of Service> 

Positive Entry 

Positive Entry 

Zero 

PROC-PB 

Updated Payable amount - when remaining balance gets pushed to the patient on closing a claim 

<Procedure_ID> - Updated receivable amount for the code with DOS <Date of Service>- Remaining amount pushed to the patient due to incomplete insurance payment 

Positive Entry 

Negative Entry 

Zero 

PPMT-CD 

Patient payment by credit or debit card 

Rcpt. #xxxxxxxx - Pat. payment credited by Credit/Debit Card - <Payment Type name> 

Zero 

Zero 

Negative Entry 

PPMT-CS 

Patient payment by cash 

Rcpt. #xxxxxxxx - Pat. payment credited by Cash - <Payment Type name> 

Zero 

Zero 

Negative Entry 

PPMT-CH 

Patient payment by check 

Rcpt. #xxxxxxxx - Pat. payment credited by Check - <Payment Type name> 

Zero 

Zero 

Negative Entry 

PPMT-CC 

Pat. payment by care credit 

Rcpt. #xxxxxxxx - Pat. payment credited by Care Credit - <Payment Type name> 

Zero 

Zero 

Negative Entry 

PPMT-CA 

Patient payment by special credits 

Rcpt. #xxxxxxxx - Pat. payment credited by Special Credits - <Payment Type name> 

Zero 

Zero 

Negative Entry 

PPMT-DT 

Patient payment by direct transfer 

Rcpt. #xxxxxxxx - Pat. payment credited by Direct Transfer - <Payment Type name> 

Zero 

Zero 

Negative Entry 

PPMT-IR 

Patient credit added as an income reduction 

Rcpt. #xxxxxxxx - Pat. payment of $xx.xx by Income Reduction- - <Payment Type name> for <provider name> 

Zero 

Zero 

Negative Entry 

IPMT-TR 

Insurance transfer to a patient 

Transferred $xx.xx from Ins. Rcpt. #xxxxxx of carrier <payer_name> to Pat. Rcpt. #xxxxx of patient <patient_name> 

Zero 

Zero 

Negative Entry 

PPMT - RU 

Payment amount of the receipt updated 

Payment Amount for Rcpt #xxxxxxxx was updated from $xx.xx to $yy.yy 

Zero 

Zero 

Positive Entry,  

Negative Entry 

PPMT-XX 

Patient receipt deletion 

Patient Rcpt. #xxxxxxxx was deleted 

Zero 

Zero 

Positive Entry 

PROC-PP 

Patient payment is applied from receipt 

Pat. Payment of $xx.xx applied from patient Rcpt. #xxxxxxx of <Rcpt owner name> 

Negative Entry 

Zero 

Positive Entry 

PROC-PA 

Adjustment against Patient component 

Adjusted <adj_amt> for patient against <Adj_ID> / <Adj_desc> 

Negative Entry, 

Positive Entry 

Zero 

Zero 

PROC-IP 

Insurance payment is applied from receipt 

Ins. payment of $xx.xx applied from payer <payer_name> Rcpt. #xxxxxxx 

Zero 

Negative Entry 

Zero 

PROC-IA 

Adjustment against Insurance component 

Adjusted <adj_amt> for insurance against <Adj_ID> / <Adj_desc> 

Zero 

Negative Entry, 

Positive Entry 

Zero 

PROC-CP 

Collection payment is applied from receipt 

Col. Payment of $xx.xx applied from col. agency <collection agency name> Rcpt. #xxxxxxx 

Negative Entry 

Zero 

Zero 

PROC-CA 

Collection commission applied against Patient component 

Col. commission of $xx.xx applied to col. agency <collection agency> against <Default Adj_ID> / <Adj_desc> 

Negative Entry 

Zero 

Zero 

PROC-TP 

Transfer from Patient to Insurance 

Transferred <adj_amt> from patient to insurance against <Adj_ID> / <Adj_desc> 

Negative Entry 

Positive Entry 

Zero 

PROC-TI 

Transfer from Insurance to Patient 

Transferred <adj_amt> from insurance to patient against <Adj_ID> / <Adj_desc> 

Positive Entry 

Negative Entry 

Zero 

CLM-S 

Claim submitted 

Claim #<Claim_ID> - Claim submitted 

Zero 

Zero 

Zero 

CLM-V 

Claim voided 

Claim #<Claim_ID> - Claim voided 

Zero 

Zero 

Zero 

PRF-CS 

Patient refund by cash 

Refunded $xx.xx from Rcpt. #xxxxxxx by Cash - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRF-CH 

Patient refund by check 

Refunded $xx.xx from Rcpt. #xxxxxxx by Check - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRF-CD 

Patient refund by credit or debit card 

Refunded $xx.xx from Rcpt. #xxxxxxx by Credit/Debit Card - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRF-CC 

Patient refund by care credit 

Refunded $xx.xx from Rcpt. #xxxxxxx by Care Credit - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRF-DT 

Patient refund by direct transfer 

Refunded $xx.xx from Rcpt. #xxxxxxx by Special Credits - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRF-SC 

Patient refund by special credits 

Refunded $xx.xx from Rcpt. #xxxxxxx by Direct Transfer - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRFI-CS 

Patient refund to insurance by cash 

Refunded $xx.xx to carrier <carrier name> from Rcpt. #xxxxxxx by Cash - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRFI-CH 

Patient refund to insurance by check 

Refunded $xx.xx to carrier <carrier name> from Rcpt. #xxxxxxx by Check - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRFI-CD 

Patient refund to insurance by credit or debit card 

Refunded $xx.xx to carrier <carrier name> from Rcpt. #xxxxxxx by Credit/Debit Card - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRFI-CC 

Patient refund to insurance by care credit 

Refunded $xx.xx to carrier <carrier name> from Rcpt. #xxxxxxx by Care Credit - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRFI-DT 

Patient refund to insurance by direct transfer 

Refunded $xx.xx to carrier <carrier name> from Rcpt. #xxxxxxx by Special Credits - <Payment Type name> 

Zero 

Zero 

Positive Entry 

PRFI-SC 

Patient refund to insurance by special credits 

Refunded $xx.xx to carrier <carrier name> from Rcpt. #xxxxxxx by Direct Transfer - <Payment Type name> 

Zero 

Zero 

Positive Entry 

ADJ-OFF 

Receipt amount adjusted 

Adjusted off $xx.xx from Rcpt. #xxxxxxx. 

Zero 

Zero 

Positive Entry 

OPPT-P 

Patient ortho payment plan terminated 

Patient ortho payment plan terminated - <Procedure_ID> - Completed <proc_desc> 

Positive Entry 

Positive Entry 

Zero 

OPPT-I 

Insurance ortho payment plan terminated 

Insurance ortho payment plan terminated - <Procedure_ID> - Completed <proc_desc> 

Positive Entry 

Positive Entry 

Zero 

MNSF-CH 

Receipt labeled as a non-sufficient fund check 

Rcpt. #xxxxxxxx - has been marked as a non-sufficient fund check 

Zero 

Zero 

Positive Entry 

UNSF-CH 

Non-sufficient fund label removed from a receipt 

Rcpt. #xxxxxxxx - NSF label has been removed from the check 

Zero 

Zero 

Negative Entry 

STMT-G 

Statement generated for the patient 

Statement generated for $xxxxx 

Zero 

Zero 

Zero 

STMT-V 

Statement voided 

Statement generated for $xxxxx on <generation date> was voided 

Zero 

Zero 

Zero 

INACT-P 

Patient has been marked as Inactive 

Patient has been marked Inactive 

Zero 

Zero 

Zero 

ACT-P 

Patient has been unmarked as Inactive 

Patient has been marked Active 

Zero 

Zero 

Zero 

BR-P 

Patient has been marked as Bankrupt 

Patient has been marked Bankrupt 

Zero 

Zero 

Zero 

RBR-P 

Patient has been unmarked as Bankrupt 

Patient bankruptcy has been removed 

Zero 

Zero 

Zero 

SYSREV & 

MANREV 

System and Manual Reversals 

For all RCM reversals, append REVERSED to the above lines and keep font as orange 

 

 

 


The various entries in the system transactions are colored differently to make them distinguishable. 

Ledger code 

Color 

PROC-D 

Mild yellow as the background color 

PROC-IP 

Mild green as the background color 

PROC-PP 

Mild green as the background color 

PPMT-_ _ 

Mild green as the background color 

CLM-_ 

Mild blue as the background color 

STMT- _ 

Purple as the font color 

SYSREV 

Light red as the font color 

MANREV 

Light red as the font color 

All other entries 

Would be in black font color without any background color 

Written by Revati Krishnan | Last published at: August 22, 2021


BluePay is a  provider of technology-enabled credit card payment processing services for enterprise, small and medium-sized businesses in the United States and Canada. Through physical POS(card processing machine), online and mobile interfaces, BluePay processes payments and provides real-time settlement, reporting and reconciliation along with robust security features such as tokenization and point-to-point encryption. 


To be able to process card/check payments within the CareStack software & Patient Portal through BluePay, the practice will need to create an account with BluePay and set up the account inside CareStack.


BluePay Transaction List


All the transactions done through BluePay would be visible under the System Menu > BluePay Transactions. This would open up the BluePay Transaction List page.

This tab will be visible only if BluePay is enabled at an account level.



Related image: ./carestack-questions-2023-03-02_files/1628081214359-1628081214359.png


The above mentioned image shows the BluePay Transaction List page.


As you can see, the grid contains various fields:

The transactions are synced each time an user navigates to this page. On the top right side of the page, you can see a filter which enables users to filter the grid. It has 3 criteria :





  




Written by Revati Krishnan | Last published at: August 22, 2021


The term non-sufficient funds (NSF), or insufficient funds, refers to the status of a checking account that does not have enough money to cover transactions. If a bank receives a check written on an account with insufficient funds, the bank can refuse payment and charge the account holder an NSF fee. Colloquially, NSF checks are known as “bounced” or “bad” checks. If a bank receives a check written on an account with insufficient funds, the bank can refuse payment and charge the account holder an NSF fee.

Non-Sufficient funds (NSF) is a term used in the banking industry to indicate that a check cannot be honored because insufficient funds are available in the account on which the instrument was drawn. A check is an 'NSF check' when it bounces due to insufficient balance in the patient's bank account. 

NSF checks are those checks given by a patient in whose bank account, amount equaling the check isn’t available. In such a situation, the practice would need to not be able to post any payments further from that receipt and at the same time does not delete it from the system. Users are able to maintain a proper audit trail as the receipt wouldn’t actually get deleted from the system. Patients could also be duly notified about the issue through statements. Once the amount comes to the practice correctly, users can use the same receipt to post payment.


Mark a Patient Check as NSF


Mark a check as Non-Sufficient Funds (NSF) by following the steps below:


Related image: ./carestack-questions-2023-03-02_files/1628010531948-1628010531948.png



Related image: ./carestack-questions-2023-03-02_files/1628010597134-1628010597134.png



Related image: ./carestack-questions-2023-03-02_files/1628010659487-1628010659487.png


  

                                                              Related image: ./carestack-questions-2023-03-02_files/1628010702150-1628010702150.png


Outcomes

Clicking Proceed will tell the system to go ahead and reverse all transactions associated with this payment; therefore the balance due to patient will increase (since that balance has no longer been met).

If part of this check was also used for other members of the account, those transactions will also be reversed.

Once the receipt is marked as NSF, you will receive a confirmation message at the top-right which says “The receipt has been marked as NSF

Related image: ./carestack-questions-2023-03-02_files/1628010900259-1628010900259.png


The receipt will now display on the grid with NSF next to the receipt number to indicate the status of this check (as well as on the ledger).


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Related image: ./carestack-questions-2023-03-02_files/1628011462916-1628011462916.png


Print a Receipt of this transaction

1. At the top of every page of the patient's profile, you'll find a row of Quick Links. Click the one on the far right titled Print.


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The Print module will open in a slide-out panel.

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2.You'll select the date of this transaction occurred, then choose the type of printout that meets your needs (examples of each type will be pictured below).


                                              Related image: ./carestack-questions-2023-03-02_files/1628012638463-1628012638463.png


3.Hit Print when you are ready. Your printout will open in a new tab for you to print or download.


Receipts (printout example): 

                                            Related image: ./carestack-questions-2023-03-02_files/1628012856757-1628012856757.png


System transactions (printout example) :

                                         Related image: ./carestack-questions-2023-03-02_files/1628012949899-1628012949899.png



Ledger (Printout example) :

                                         Related image: ./carestack-questions-2023-03-02_files/1628013017200-1628013017200.png


Unmark a Patient Check as NSF




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Related image: ./carestack-questions-2023-03-02_files/1628013236957-1628013236957.png

The following warning message will appear: “This will remove the NSF tag from the receipt and the receipt amount will be reinstated as Unapplied credits in the receipt”

                                                       Related image: ./carestack-questions-2023-03-02_files/1628013301903-1628013301903.png

 

If you choose to proceed, you will receive a green confirmation message at the top-right of the screen: “NSF label has been removed from the receipt”. This payment will now be available to apply towards any outstanding balances.

Related image: ./carestack-questions-2023-03-02_files/1628013724896-1628013724896.png


Written by Roshni R | Last published at: August 18, 2021


Edit Insurance Receipt


With the appropriate permission settings, users are able to edit an insurance receipt's details as needed by following these steps below:

1. From your system menu, select  Insurance Payments.

                                        Related image: ./carestack-questions-2023-03-02_files/1628005791989-1628005791989.png


2. When the page loads, locate your intended receipt on the left side menu, then click  Edit  and make your necessary changes in the drop-down box. All fields in the Receipt would be auto-populated with the currently saved data.


Related image: ./carestack-questions-2023-03-02_files/1628005879955-1628005879955.png


3.Hit  Save  when you are done. You will receive a green confirmation message on the top right of the screen : " Receipt updated successfully. "

                                                    Related image: ./carestack-questions-2023-03-02_files/1628006021300-1628006021300.png

The following details of an insurance receipt should be allowed to be edited after it has been added.


Impact Areas


All changes made will be separately logged in the  Receipt History  section of the corresponding insurance receipt details and it is audited in the Audit Trail as well.


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Related image: ./carestack-questions-2023-03-02_files/1628006339397-1628006339397.png


Updating the details of an insurance receipt will also update the same corresponding information provided in the following areas:

Permissions


Only users with Add/Edit Insurance Payments permission should be allowed to edit the details.

Related image: ./carestack-questions-2023-03-02_files/1628006473390-1628006473390.png



Edit Patient Receipt


With the appropriate permission settings, users are able to edit a patient receipt's details as needed by following these steps below:

1.Navigate to Patient’s Billing  > Payments > All Payments.

2.Locate the intended receipt under the All Payments tab or the Refund/Adjust-Off tab.


                       Related image: ./carestack-questions-2023-03-02_files/1628009835075-1628009835075.png


Related image: ./carestack-questions-2023-03-02_files/1628009859447-1628009859447.png


If the payment has already been allocated towards completed treatments, you will have to checkmark the option "Show Receipts without Available Credits" (pictured above).


3. Once the intended receipt is located, click on it to open the Payment Details window.

4. Click Edit Payment Details on the bottom right of the pop-up window.


Related image: ./carestack-questions-2023-03-02_files/1628009947201-1628009947201.png


5. After making the changes in the intended receipt, you can click on Save.


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You will receive a green confirmation message on the top right of the screen : " Receipt updated successfully. "


                                                      Related image: ./carestack-questions-2023-03-02_files/1628010093351-1628010093351.png


Please Note:

The following details of a Patient receipt should be allowed to be edited after it has been added.


Impact Areas


All changes made will be separately logged in the  Receipt History  section of the corresponding insurance receipt details and it is audited in the Audit Trail as well.


Related image: ./carestack-questions-2023-03-02_files/1628010179997-1628010179997.png


Related image: ./carestack-questions-2023-03-02_files/1628010216749-1628010216749.png



Permissions


Only users with Add/Edit Patient Payments permission should be allowed to edit the details.


Related image: ./carestack-questions-2023-03-02_files/1628010269960-1628010269960.png


Written by Athul V Suresh | Last published at: August 08, 2021


The completed procedure code grid shows the list of completed procedure codes for the patient.


To access the grid navigate to Billing > completed procedure code.


Related image: ./carestack-questions-2023-03-02_files/1628074957068-1628074957068.png


Or you can access the universal completed procedures grid for your practice  By navigating to System menu > Completed procedures 


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Related image: ./carestack-questions-2023-03-02_files/1628075006240-1628075006240.png



The completed procedure grid has the following columns,



Reversing Payments


To reverse payments you can select the row and click on actions and select the reverse option.


Related image: ./carestack-questions-2023-03-02_files/1628074858037-1628074858037.png


This will reverse all only all the transactions (payments & adjustments) applied to the code.

Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


Overview


Let's face it. Dental treatment can be expensive, and even if the patient is lucky enough to have insurance, it probably won't cover everything. 

The more options you give your patients to pay for treatment, the more likely it is that they will. With CareStack, you can offer a payment plan as an option. 

A Payment Plan is a set of structured regular payments against a balance or future treatment. It's a little like a credit card. The cost of the treatment is the balance and then the patient pays a little each month to reduce the balance.


Before You Start a Plan


Payment plans connect the patient's current balance or anticipated charges with the details of how the patient will pay the charges over time.

Adding a payment plan in CareStack is almost as easy as entering a payment, but there are three separate components:

Let's look at those before we get clicking.

Financed Amount

The financed amount is the total balance we’ll be spreading into payments over the life of the plan. It starts with a simple calculation: Total Amount – Down Payment = Financed Amount.

There may be one small wrinkle in the calculation. If your practice charges interest on the amount financed. You will need to know the APR (Annual Percentage Rate). CareStack will calculate the interest and add it to the financed amount. 

Once you know the financed amount, we'll need to figure out how to spread that amount over time into the regular payments.

Periodic Payments

The periodic payment is the amount that will be paid each period for the life of the plan. It too is a simple calculation: Financed Amount ÷ Number of Payments = Amount of Payment

CareStack will do that calculation for you and even turn it around and figure out the number of payments for a specific amount.

With these details in hand, you are ready to add your payment plan. 


Add a Payment Plan


Payment plans are added in the Payment slider just like regular payments. To add a payment plan: 

  1. Select the Payment Plan option.
  2. Complete the details for the payment plan.
  3. Click Pay with BluePay.

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Related image: ./carestack-questions-2023-03-02_files/1628099363968-1628099363968.png

Your Truth In Lending Agreement will open automatically for the patient's signature. If you are using BluePay, you'll be ready to charge the patient's card for using the BluePay partner window. 

Related image: ./carestack-questions-2023-03-02_files/1628528944689-1628528944689.png



Periodic Billing


Though CareStack does most of the work, you might want to check into the payment plan details. They are held for you on the Payment Plan tab in the Payments slider. 

View the periodic schedule by clicking the plan's row. 

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Related image: ./carestack-questions-2023-03-02_files/1628101267852-1628101267852.png

Not only can you see the periodic payment structure in the window, but you can also use it to edit or skip a payment in the series. To edit a payment:

  1. Click the Edit link beside the payment
  2. Change the payment amount. 
  3. Click Save. 

Related image: ./carestack-questions-2023-03-02_files/1628102189074-1628102189074.png

When you edit a payment, CareStack recalculates the remaining payments to incorporate the changed payment. 

Applying Credits

Your practice will decide how to handle payments made through these plans. Some choose to credit them to the patient balance directly; others prefer to hold the credits as unapplied so they can be allocated appropriately. 

If your practice holds them as unapplied, you will need to apply them. To know how to apply credits, kindly refer the end of this article.


Edit Or Terminate A Plan


You carefully built your patient payment plan so the patient would pay the initial payment and each periodic payment after that until the treatment was paid for. But things happen and sometimes you'll need to change or give up on a plan.

We'll begin on the Payment Plans tab in the Payment Slider or in the Payment Plan Control Center. 


Edit a Plan

You won’t be able to edit every field, but you can work with the total. It is especially helpful if the patient’s insurance covered more or less than you anticipated. 

You can edit: 

To edit a payment plan: 

  1. Open the desired plan.
  2. Click Edit.
  3. Update the relevant details for the payment plan. 
  4. Click Save.


Related image: ./carestack-questions-2023-03-02_files/1628271816951-1628271816951.png

Related image: ./carestack-questions-2023-03-02_files/1628271844348-1628271844348.png




Terminate a Plan

You would terminate a payment plan if the patient is discontinuing treatment or if this payment plan no longer suits them because of the number of payments. 

To terminate a patient payment plan: 

  1. Open the desired plan.
  2. Click Terminate
  3. Confirm by clicking Proceed.  


Related image: ./carestack-questions-2023-03-02_files/1628271875957-1628271875957.png


Written by Rinu Seba Joemon | Last published at: August 22, 2021


Overview

The ‘Payment Details’ pop-up window of a receipt provides CareStack users with plenty of information regarding the completed patient payments. The payment details pop-up opens up when a receipt is selected. Please see the image below for an indication of how the window will appear.

Related image: ./carestack-questions-2023-03-02_files/1628260319414-1628260319414.png


Workflow

This could either be done by navigating to the patient's Overview > Billing > Payments > All payments > Select the receipt. 


Related image: ./carestack-questions-2023-03-02_files/1629540123571-1629540123571.png

You can click on the ‘Go to Ledger’ icon to directly move to the patient ledger.

Or else, navigate to the patient's Overview page > Billing > Ledger > You will be able to see the patient's payment on the patient ledger with the receipt number > Click on the 'more info' icon in the blue colored text under the description column. 


Note: Clicking on the payment receipt row highlights the codes associated with the receipt in red pale color as you could see in the below image.

You can also get the patient payments receipt by navigating to the System Menu > Billing > Patient Payment > Search for the receipt.


Receipt Details:

Now let us go through each tab in the payments details window. There are five tabs in the payment details window.

  1. Receipt Details
  2. Transactions
  3. Refunds
  4. Adjust-Off
  5. History
  1. Receipt Details


The receipt details tab includes the below details.

 

 

 

 

 

 

 

 

BluePay is a leading provider of technology-enabled payment processing for merchants and suppliers of any size in the United States and Canada.

Apex is a payment gateway similar to BluePay.

 

  

  1. Transactions


The transactions tab shows all the transactions that were completed under this receipt. Reversing transactions is possible in this tab. You just have to tick mark the transaction(s) that you want to reverse and click on the ‘Reverse’ icon.


  1. Refund


The refund tab shows the payment refunds that were completed under this receipt, The refunds can be reversed by tick marking and clicking on the ‘Reverse Refund' icon.


  1. Adjust-Off


The Adjust-Off tab contains all the adjustments that have been done in the receipt. Similar to refunds the adjustments also can be reversed from the receipt by tick marking the square box and by clicking on the ‘Reverse Adjust-Off’ icon.


  1. History


As the name suggests the history tab contains all the transaction history of the receipt. 











Written by Athul V Suresh | Last published at: August 15, 2021


The Code has been completed and multiple payments and adjustments have been made. Where can we go to print out the same? The payment summary will help you with that.


To access payment summary navigate to the Billing > Payments > Print Payment Summary.


Related image: ./carestack-questions-2023-03-02_files/1628522624729-1628522624729.png


Related image: ./carestack-questions-2023-03-02_files/1628522695829-1628522695829.png


The payment summary contains the total patient balance, total insurance balance the patient owes till the date of generation of the payment summary.


     Related image: ./carestack-questions-2023-03-02_files/1628522564830-1628522564830.png 


It also shows the patient due and ins due balance according to aging buckets.


Related image: ./carestack-questions-2023-03-02_files/1628522792116-1628522792116.png



The aging buckets are grouped into buckets of 0-30days, 31-60 days, 61-90days, and older dues greater than 90 days.



If the patient has any future appointments after the day of generation of payment summary that would show up too.


Related image: ./carestack-questions-2023-03-02_files/1628523013667-1628523013667.png

The most important thing to note is that the payment summary will be printed based on the transaction date  All payments and balances due before the date of generation will be shown in summary as previous balance.


How data is organized in the payment summary 


The ins balance and patient balance are displayed in the payment summary based on the date of generation. 


If N codes are marked as completed today irrespective of the date of completion those codes will have separate entries on the payment summary.

Similarly, if N payments are entered in CareStack today these payments will have separate entries irrespective of the actual payment date.


 Related image: ./carestack-questions-2023-03-02_files/1628523059500-1628523059500.png


All other transactions done previous to the day of generation of payment summary will only be displayed after calculating the sum total in the previous balance row.


Previous balance is the balance in the patient's account after deducting the credits in the account from the balance the patient owes for complete procedure codes.


The payment summary will show the code and payment details for all patients in the account. It will show receipts added through all payment types.


Entries in the payment summary.


Actions 
     Entry descriptions
Procedure checked out 
<Procedure_ID> - Completed <proc_desc> with DOS <Date of Service>
Patient payment by any payment type
Rcpt. #xxxxxxxx - Pat. payment credited by <Payment Category - Payment Type>
Patient payment by special patient credit
Rcpt. #xxxxxxxx - Pat. payment credited by special patient credit <adjcode><adjdesc>
  Patient credit added as provider payback
Rcpt. #xxxxxxxx - Pat. payment of $xx.xx credited as provider payback amount 
Pat. payment by care credit
Rcpt. #xxxxxxxx - Pat. payment credited by <Card type> type care credit 
Patient payment credited as Other
Rcpt. #xxxxxxxx - Pat. payment of $xx.xx credited by other (Ref # xxxxxxx)
Receipt amount partially reversed
Credited back off $xx.xx to Rcpt. #xxxxxxx.
Insurance transfer to patient
Transfer: $xx.xx from Ins.Rcpt. #xxxxxx from payer <payer_name> to Pat.Rcpt. #xxxxx of patient <patient_name>
Insurance payment by any payment type
Rcpt. #xxxxxxxx - Ins. payment credited by <Payment Category - Payment Type>
Collection payment by any payment type
Rcpt. #xxxxxxxx - Col. payment credited by <Payment Category - Payment Type>
Adjustment against Insurance component
<Procedure_ID> - <adj_amt>adjusted for insurance against <Adj_ID> / <Adj_desc>
Collection commission applied against Patient component
Collection commission applied against Patient component

Transfer from Insurance to Patient 

<Procedure_ID> - <adj_amt> transferred from insurance to patient against <Adj_ID> / <Adj_desc> 
Transfer from Patient to Insurance
<Procedure_ID> - <adj_amt> transferred from patient to insurance against <Adj_ID> / <Adj_desc>
patient by any payment type 
Refund: Rcpt. #xxxxxxx $xx.xx by <Payment Category - Payment Type>
Patient refund to insurance by cash/check
Refund to carrier: Rcpt. #xxxxxxx $xx.xx by cash/check
Patient ortho payment plan terminated
Patient ortho payment plan terminated - <Procedure_ID> - Completed <proc_desc>
Insurance ortho payment plan terminated
Insurance ortho payment plan terminated - <Procedure_ID> - Completed <proc_desc>
Receipt labeled as a non-sufficient fund check
Rcpt. #xxxxxxxx - has been marked as a nonsufficient fund check
NSF label removed from a receipt

Rcpt. #xxxxxxxx - NSF label has been removed from the check 


Written by Mathew Kandirickal | Last published at: August 08, 2021


Pre-Authorizations


Insurance claim is the tool for getting paid for completed treatment from the patient's insurance company. To speed up the claims process, many practices will submit a pre-authorization request before treatment is completed; or sometimes an insurance plan might define which procedures will require a pre-authorization check with them first before moving forward.

With pre-authorization, the practice will submit the treatment codes to the carrier and ask what they will pay, instead of completing the treatment and then crossing their fingers and hoping they pay.

  

Dental Authorization Status Flow 


Paper Based Authorizations

 

 

Electronic Authorizations

 

 

 

 

 

 

 Medical Authorization Status Flow 


 

 

 

Written by Rinu Seba Joemon | Last published at: August 18, 2021


Overview:

Insurance claims are your tool for getting paid for completed treatment from the patient's insurance company. Many practices will submit a pre-authorization request before treatment is completed to speed up the claims process. Or sometimes, an insurance plan might define which procedures will require a pre-authorization check with them first before moving forward.

With pre-authorization, you submit the treatment codes to the carrier and ask what they will pay, instead of completing the treatment and then crossing your fingers and hoping they pay.

Note:  An Authorization is NOT a guarantee of payment.

Permissions: 

To enable permissions kindly navigate to the System Menu > Practice Settings > Administrations > Profiles > Click on Manage Permissions Next to the profile you want to enable permissions > Claims > Authorizations > Mark Yes for the permissions you want to enable > Click on Save.

Related image: ./carestack-questions-2023-03-02_files/1628787810508-1628787810508.png


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Audit Trail:

The activities that have been done by any user would be reflected in the audit trail. To see these details you may navigate to the System Menu > Operations > Audit Trail.

Related image: ./carestack-questions-2023-03-02_files/1628787962419-1628787962419.png

Authorization Dashboard:

To see the authorization dashboard you may navigate to the System Menu > Billing > Pre authorizations.

Related image: ./carestack-questions-2023-03-02_files/1628788003669-1628788003669.png

The Authorizations tab is the first page you'll see. It lists all authorizations that currently exist in your system.

Note: Select the Dental or Medical tab at the top to view only the relevant authorizations.

Related image: ./carestack-questions-2023-03-02_files/1628788087364-1628788087364.png

Related image: ./carestack-questions-2023-03-02_files/1628788212376-1628788212376.png



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How to Raise Pre-Authorization Manually?:

Manually start an authorization by following the steps below:

Option 1: Navigate to the System Menu > Billing > Pre-Authorisation > Authorizations dashboard > Click Add at the top-right to start an authorization from scratch.   

Note:  Any procedure codes that are added to the authorization from here will not be added to the patient's treatment plan.

Option 2: Navigate to the patient’s Overview > Clinical > Treatment Planning > Locate the procedure codes that you want to raise a pre-auth > Select the relevant procedure codes, then right-click and select Create Auth Request.

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Note: A pre-authorization can be raised only for those codes that have a billing order ‘D’ and the status of the codes should be either Proposed or Accepted. For completed codes, a Pre-Authorization cannot be raised.

How to Submit an Authorization to Dental?

When an authorization claim is drafted, you will still need to review it and submit it to insurance.

  1. From the patient's profile:  Hover over Billing on the left side navigation panel, then select Authorizations or you may navigate to the System Menu > Billing > Pre authorizations.Related image: ./carestack-questions-2023-03-02_files/1628789008378-1628789008378.png
  2. Click on the authorization claim to open it, then review the following information in the ‘DETAILS’ tab:
  3. Save & Continue will take you to the  Codes tab.


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  1. Hit the Save & Continue icon to move forward.
  2. Save as Draft icon will allow you to save and come back to complete this claim at a later time.
  3. The Advanced Edit icon will take you to the claim form to review and complete the form line by line.

Save & Continue will take you to the  Codes tab.

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      4. The Authorization Form tab (advanced editing):  Here, you can review the claim for accuracies such as the place of treatment (line #38) if your doctor was performing at a hospital other than your usual clinic for example.

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 The sections included in this form are as follows:

When you are finished and ready to submit:

Some practices like managing their electronic claim status and payments using Change Healthcare's claim management program, Dental Connect. Otherwise, keep an eye out for the carrier's response (whether by phone, online, or mail correspondence) and once the authorization response is received, you can return to CareStack to complete the response details, update the expected receivables if necessary, and continue with the next steps of your patient care process.

Manually Complete an Authorization Response: 

Once you receive the carrier's response, you can navigate to the authorization in CareStack (from the patient's profile or the Authorizations dashboard) to record the authorization response.

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  1. At the top of the window, enter the:  Authorization Number,  Effective Date,  and Expiration Date.
  2. On the grid, you'll select the status of the code (Covered or Not Covered), then enter the actual patient and insurance estimates according to the authorization response.
  3. Enter any necessary notes at the bottom, then hit Save & Complete. The authorization status will now reflect a  Completed status, and you can update the expected collection for the patient's treatment if necessary.


Enter and Complete an Authorization to Medical:

Some health plans require you to run a pre-authorization before completing specific procedures. You'll raise the authorization as normal (from the advanced planner or appointment details), but only the procedure codes with an  M  or  MD  billing order will create a medical authorization.

To save the medical authorization request:

  1. Hover over Billing on the left side navigation panel of the patient profile, then select Authorizations Or,  System Menu > Pre-Authorizations to see authorizations for all patients.
  2. Click on the authorization claim to open it, then review the following information:

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 Details 

Auth Response

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3.Once you have obtained a response from the health plan, you can record the Auth. Response in CareStack before setting it to  Complete by following these next steps:  Navigate to the relevant authorization request, then click on it to open.

You will see the following response details:

Authorization History

The authorization history shows the history of medical pre-auths.

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Pre-Authorization Remittance Advice(ERA):

To access Electronic Remittance Advice received from insurance carriers for your pre-authorization requests, follow these steps below:

Navigate to the System Menu >Billing >  Electronic Remittance > When the page loads, click the  Pre-Authorization Remittance tab at the top-left.

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Note:  In the above example, the patient name did not match a patient that is currently in the system. This often happens if the patient goes by their maiden name or a nickname. Simply match this to the correct patient by selecting them at the bottom.


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Automatic Pre-Authorization:

Specifying these procedure codes requiring a pre-authorization in an insurance plan ensures the required authorization claim is created at the time of treatment acceptance. Simply follow these steps below:

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Note: This tells the system that whenever a patient with this insurance plan accepts treatment including one of the codes specified here, an authorization claim should be drafted for you to send to the carrier.


Results:

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This is all about pre-authorizations. Try this on your own now!


Written by Geo Thomas | Last published at: August 19, 2021


Eligibility Rules


Carriers have many rules that can impact if a service will be covered. CareStack calls this section Limitations and Exclusions. Some carriers include these details in Benefit Levels, or Covered Services.

These are the most common eligibility rules(with examples)

Setting up the eligibility rules

The eligibility rules could be set up under a plan by navigating to System Menu> practice Settings> Plans


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After selecting the Plan, navigate to the Benefits tab and click Edit at the bottom right corner of the pop-up screen. Under the Exclusions and Limitations section, the user would be able to set the eligibility rule for each code. It is to be noted that no new additions can be made to this list as CareStack follows a fixed template for this.


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Setting up a patient’s Limitations and Exclusions


This could be set by clicking Limitations inside a patient’s insurance.

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The user would be able to edit the list of limitations and set eligibility rules from here by clicking Edit.


Here, only the Benefit Rem.(benefit remaining) section would have any effect on the patient’s insurance coverage as all other fields are set at the plan level. If it is unchecked, it means the patient has no remaining benefits after considering that particular limitation. But it is to be noted that this would not automatically apply to the code. This data is only for informational purposes. The user would have to set the Billing Order of the code as N manually.


After making the required changes, the user would have to click Save and Update Eligibility


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Permissions required


The minimum required permissions to set the limitations and exclusions of a patient are as in this image.


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FAQs

1. The patient is not eligible for coverage as he/she is over the allowed age limit. Why is the insurance estimate still being calculated?
A. The eligibility details are only for information purposes. They do not have any effect on the patient's coverage. If the Benefits Rem. is marked as No, the billing order of the code is to be changed to N



Written by Mathew Kandirickal | Last published at: August 08, 2021


The Alternate Benefit Clause is a stipulation in many dental plans stating that certain dental procedures must convert to a less expensive treatment. The patient can still receive the more expensive treatment but is reimbursed for the amount of a procedure that 


1) is less expensive

2) serves the same function. 


The most frequently cited examples of the AMB clauses being administered are when composite fillings are alternately benefited to amalgams and when crowns are alternately benefited to large fillings. Although there may be alternative treatments that are clinically acceptable, often the least expensive treatment may not be what is in the best interest of the patient. 


Points To Note 


     

Tooth Set

Maxillary Teeth

Mandibular Teeth

Anterior Teeth


#6-#11/ #C-#H


#27-#22/#R-#M


Posterior Teeth


#1-#5, #12-#16/#A,#B,#I,#J


#17-#21, #32-28/#T,#S,#L,#K



Setting Up AMB Codes



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The same section can be seen under the Patient Eligibility section, under the tab Pre-Authorization Codes / Alternative Benefit Codes

When there is a code with an AMB code and deductible. Code A is a treatment code with Fee = X.  Code B is the AMB code with Fee = Y (Ins payable is IP which is obtained using the percentage splits) and the Deductible = Z


Examples




Written by Renganathan K | Last published at: August 22, 2021


Some individuals and families have secondary insurance plans, which could “fill the gaps in a policy holder’s dental or medical coverage. Gaps in coverage can occur when the primary policy’s annual spending limit is reached, or when a policy doesn’t provide coverage for necessary or desired dental treatments” (“Supplemental Dental Insurance”). Since some dental insurance provides little to no coverage for more expensive treatments, dual coverage helps make treatments more affordable for patients. However, clinics and patients must follow its rules and policies.

Patients must categorize their primary and secondary insurance plans. According to the Delta Dental website, “The general rule is that the plan that covers [the patient] as an enrollee is the primary plan and the plan which covers [him or her] as a dependent is the secondary plan” (“If you are covered by two dental plans”). For instance, a patient’s insurance plan from the employer is primary, while his or her spouse’s plan is secondary (Lowery 2016). Regarding their children, clinics and patients must follow “the birthday rule,” which means that the “coverage of the parent whose birthday—month and day, not year—comes first in the year is considered to be [the parents’] children’s primary coverage” (“If you are covered by two dental plans”). In a divorce, the parent to whom the court chose for “financial responsibility for the child’s health care bills” has the primary plan (Duncan 2013). However, if the court does not choose a parent for this responsibility, the birthday rule will still be in effect (Duncan 2013). For an individual with two jobs that provide dental insurance plans, “the primary plan is usually the one that has provided coverage the longest” (Lowery 2016).

Hierarchy assignment comes into picture when the patient has more than one insurance plan. Defining a Hierarchy is very important as this plays a major part in the billing process. You can use the global search bar to find the patient and then click on the insurance shortcut.


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Make use of the Hierarchy Assignments button to change the hierarchy.


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Once you click on this you will be greeted with a popup window.


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Make the necessary hierarchy assignments for each account member's insurance plans, then click Save.


Auto- Assignment of Insurance Hierarchy

Insurance hierarchy would be auto assigned when an insurance is added to a patient. 

  Action   Context   Expected
 A new dental insurance is added No prior dental insurance Upon addition, the plan should be auto-assigned as primary dental
A new dental insurance is added 1 or more existing unverified dental insurances Upon addition, the plan should be auto-assigned as primary dental
 A new dental insurance is added 1 or more existing verified but unassigned ins Upon addition, the plan should be auto-assigned as primary dental
A new dental insurance is added Previously assigned but terminated pri ins

a) If the new ins is "self" Upon addition, the plan should be auto-assigned as primary dental

b) If the new ins is not self AND secondary is self (and not terminated) Upon addition, secondary ins becomes primary and the new ins becomes secondary

c) If the new ins is not self AND secondary is not self/is terminated/not assigned Upon addition, the plan should be auto-assigned as primary dental



A new dental insurance is added Already assigned and not terminated primary dental ins, but no/terminated secondary ins

a) The primary ins is "self" Upon addition, the new ins should be auto-assigned as secondary dental

b) The primary is not self AND new ins is "self" Upon addition, new ins should be auto-assigned as primary dental and the existing primary should become secondary

c) The primary is not self AND new ins is not self Upon addition, the new ins should be auto-assigned as secondary dental



A new dental insurance is added Already assigned and not terminated primary and secondary dental ins

a) Primary and Secondary are self Upon addition no change in assignments

b) Primary is self, secondary is not self and new ins is self  Upon addition, the new ins should be auto-assigned as secondary dental

c) Primary is self, secondary is not self and new ins is not self  Upon addition, no change in assignments

d) Primary and Secondary are not self and New ins is self Upon addition, new ins becomes primary and the existing primary becomes secondary. 

d) Primary, Secondary and New ins are not self Upon addition, no change in assignments



A new medical insurance is added No prior medical insurance Upon addition, the plan should be auto-assigned as primary medical
A new medical insurance is added 1 or more existing unverified medical insurances Upon addition, the plan should be auto-assigned as primary medical
A new medical insurance is added 1 or more existing verified but unassigned ins Upon addition, the plan should be auto-assigned as primary medical



A new medical insurance is added Previously assigned but terminated pri ins

a) If the new ins is "self" Upon addition, the plan should be auto-assigned as primary medical

b) If the new ins is not self AND secondary is self (and not terminated) Upon addition, secondary ins becomes primary and the new ins becomes secondary

c) If the new ins is not self AND secondary is not self/is terminated/not assigned
Upon addition, the plan should be auto-assigned as primary medical
A new medical insurance is added Already assigned and not terminated primary medical ins, but no/terminated secondary ins

a) The primary ins is "self" Upon addition, the new ins should be auto-assigned as secondary medical

b) The primary is not self AND new ins is "self" Upon addition, new ins should be auto-assigned as primary medical and the existing primary should become secondary

c) The primary is not self AND new ins is not self Upon addition, the new ins should be auto-assigned as secondary medical



A new medical insurance is added Already assigned and not terminated primary and secondary medical ins

a) Primary and Secondary are self Upon addition, no change in assignments

b) Primary is self, secondary is not self and new ins is self  Upon addition, the new ins should be auto-assigned as secondary medical

c) Primary is self, secondary is not self and new ins is not self  Upon addition, no change in assignments

d) Primary and Secondary are not self and New ins is self Upon addition, new ins becomes primary and the existing primary becomes secondary. 

d) Primary, Secondary and New ins are not self Upon elig verification, no change in assignments

Written by Abhishek Vijay | Last published at: August 09, 2021


The patient came over, the provider completed the procedure, the code was added and completed. The patient then paid his dues and settled his debt with the practice, what's next?

Here is where the insurance companies and their corresponding insurance plans come into play. Depending on the kind and breadth of the insurance plan, dental insurance can assist cover the costs of dental treatment, ranging from basic preventative coverage to extensive dental work.

CareStack can bill and send completed procedures to the insurance companies. The insurance companies then verify the claim sent to them and cross-check it with the patient's benefits. Once they obtain an estimate of the amount to be paid, they will share a document called "Explanation of Benefits" (EOB), which will address the financial details of the sent claim and the payment for the same.

Once the user receives the same, we can initiate the process of insurance payments. Let's begin by having a look at how to add an insurance payment receipt.

Insurance Payment Receipts


Once we receive the payment from the insurance, the user has to create an insurance payment receipt to reflect the payment on to CareStack. Once the receipt is added, similar to adding a patient payment, the user can credit the codes with the insurance portion.

To add an insurance payment receipt, we have two methods:

From the Ledger

While on the patient's ledger, you can add the insurance payment receipt via the Add Payment option at the top.

Ledger > Add Payment > Add Insurance Payment

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Once here, you may select the Add New Payment option to create a new receipt.

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You may then select the carrier and then fill in the necessary payment details. Once the details are entered, click on save to create the insurance payment receipt.

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From the Insurance Payments Module

Another method is to create a receipt via the Insurance payments module on the System Menu.

System Menu > Insurance Payments > Add New Payment

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Once all the relevant details are filled in, you may click on Save to create the receipt, just like the previous method.

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Once the receipts have been added fresh, or if there is already a receipt added, we can move forward to posting an insurance payment.


Insurance Payment Posting


Now it is time to allocate the amounts received from the insurance into the completed codes as the insurance portion. We can break this process down into 3 steps.

                                                    Related image: ./carestack-questions-2023-03-02_files/1628428696124-1628428696124.png

Similar to creating a receipt, we can post the insurance payments from the ledger, as well as the insurance payments page.


From the Ledger

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From the Insurance Payments Module

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As you may have seen, there are five different options once the patient is selected. Let us go through each section in detail.

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Once we click on the insurance payment receipt and search and select the patient from the drop-down list, the default setting of the claim payment is Pending Payment. The state signifies that the claim has been sent out from CareStack, and is awaiting action from the Insurance carrier. To post the insurance amount to a patient's completed procedures, we have to shift the status from Pending Payment to any of the below-mentioned statuses.

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With our patient selected, we are ready to apply the payment to the claim. Naturally, we like it best when the payment matches what we expected. If the insurance paid exactly as we expected, we can just select the "Paid as Expected" option and then click on submit. You're not mistaken, that is all there is to it! The payment has been successfully applied to the codes and will be visible on the ledger.

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Some practises may elect to apply insurance payments and modifications to the whole claim amount by completing them on the total claim amount, rather than through individual codes. CareStack will automatically calculate the difference between the insurance payment and the expected insurance payment, allowing you to decide what to do with the under or overpayment.

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When the payment received from the carrier on the claim for one or more codes is different than what was expected, we complete the payment via the line payment method. It is called line level because you apply the payment to each code line separately. CareStack will use the information to apply the adjustments following the logic you just learned. Many practices decide to post the payment on the line item level to carefully describe the applied payment and its actions, such as any adjustments made. 

Under the claim posting scenarios, we often use the Line Payment Method to post the amounts in the case of the patient having dual insurances. Take care to always post the primary payment first, so that the payment hierarchy is not affected. Let's have a look at an example of the same.






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If the claim was rejected due to any number of reasons, we can mark the collective treatment codes as denied. Once this option is selected, you would have to specify the rejection reasons via the Group Code and Reason code, which would be specified on the insurance EOB received. Once all the fields have been entered, we may click on Submit to post the codes as denied, and push the balance towards the patient or write it off as required.

Adjustments

Sometimes what we billed and expected isn't what we receive. For one reason or another, the carrier has paid more or less than we expected on at least one code.  

Sometimes the payments are greater than you expected. You might find this when: 

When payments are less than you expected, it might be because: 

Whatever the reason for the carrier paying more or less than we expected, we need to account for what happened in CareStack. You cannot change what you got. Instead, you must change what you thought. The solution is to add sufficient adjustments while posting the payment.


An adjustment is a way of expressing an action. The action increases or decreases either the patient side or the insurance side so what you expected matches what you got. 

When one goes up and the other goes down by the same amount, it is processed as a transfer. 

CareStack will add adjustments for you to do just that, but you'll want to understand how that happens.

Examples 

We submitted a claim for an extraction. Using the code's details, let's decide what adjustments CareStack will use when we receive different amounts. 
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Example A 

The carrier pays $165 and expects the patient to pay $30. What adjustment would be needed?

Adjustments: 

Example B


The carrier pays $110 and expects the patient to pay $40. What adjustment would be needed? 


Adjustments:
 


Submission and Results



The final part of the process is to click the submit button as part of applying the funds. It’s the final step that formalizes what you’ve done by posting the payment and any adjustments or transfers. 

At this stage, we are going to explore the results when you click Submit.

Payment Receipt

The Payment Receipt always reflects the amount of the payment yet to be applied (available credits)  as well as the amount of the original payment. 

After you apply a payment to a claim, the remaining credits in the payment are reduced by the amount you just applied. That will be shown in red on the receipt and within the receipt tile. 

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Receipt’s History Tab

 

The Receipt History tab shows the application of the payment against the codes included in the claim.


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Patient Ledger

The patient's colorful ledger displays a great deal of information about the claim, payments, and component procedures.

Claim lines are bluepayments are green, and adjustments are yellow for quick identification. Each contains a link for additional details. Many of these line items also have a more information link.

You may click on the More Info link on the claim line to show the claim or click on the More Info link on the payment line to show details of the insurance receipt.

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 Claims Module

Even after the claim is closed, you'll be able to find it in the All Claims tab in the Claims module with the Closed status. A patient's closed claim can also be found in the Claims area of the patient profile.

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Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


CareStack makes it easy to manage both bulk and single insurance payments in the Insurance Payment module. There are two ways to add Insurance Payments within CareStack:

From the Insurance Payments Module

If you aren't already there, yet, navigate to the Insurance Payments module by selecting Insurance Payments from the System Menu.

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1. Click Add New Payment in the upper-right corner.

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2. In the pop-up window, select the Insurance Carrier, then enter the following payment details:

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The Carrier Details are also shown on the right.


3. When you are finished entering the payment details,  hit  Apply to begin allocating the payment towards the relevant insurance claims, or hit  Save to save this payment come back to it later. 

You will receive a green confirmation message:

" Transaction completed successfully. "

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From the Patient's Ledger

1. Navigate to the Patient's Ledger by following any of the methods within this article.

2. When the page loads, select  Add Payment > Add Insurance Payment in the upper-right corner.

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3. In the pop-up window, proceed as follows:

Selecting Use Existing Payment and selecting a receipt would direct you to to the Insurance Payments page in order to apply payments against the receipt.

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You would then be redirected to the Insurance Payments page, to apply the payments against that particular receipt that you selected.

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In our case, we shall select Add New Payment to proceed to add a new insurance payment and complete the following details:

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4. Hit  Apply to save the payment and begin applying it.

Next, the pop-up window will display the patient's open claims, allowing you to begin allocating the payment towards the necessary procedures.

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Written by Aswathy B Nair | Last published at: August 08, 2021


Sometimes patients have more than one insurance plan to cover their dental treatments. 

When there are two plans, you need to account for the differences in benefits and coverage and

manage the payments between the carriers.


To deal with such cases, we would have to follow the process just like in the case of patients with one insurance but a little more, which we will look upon in the coming sections.


Attach a Secondary Plan


Attaching a separate or secondary plan is nothing more than attaching a primary insurance.

  1. Select or enter the Subscriber.
  2. Enter the Subscriber ID or SSN and Effective date of the plan if you have those details available.
  3. Locate or add details for your plan, by finding it in your database, entering draft details, or adding a new plan.
  4. Select any other patients from the account that need to be added under the same plan and set their relationship to the subscriber.
  5. Decide if you are ready to complete the plan and select the Mark Insurance as Verified checkbox accordingly.
  6. Click Save.

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Hierarchy

Once the plan is added, you would have to set the Hierarchy. Hierarchy tells which plan has the first benefit and payment priority. You can set the Hierarchy from the Hierarchy Assignments o the Insurance page of patient.

  1. Click Hierarchy Assignments
  2. For each patient, set the hierarchy for each plan from the drop down list
  3. Click on Save.

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Secondary Claims


No that we have seen how to add a Secondary Insurance, we shall go ahead and see how to create a secondary claim by which we request the carrier for the payment of the treatments. Billing order determines whether the code needs to be billed for a single carrier or for more.

Billing Order

Billing Order determines how the codes should be billed. You can see the Billing Order of the codes from the Treatment Planner or from the Code Snapshot.

Also you may use the combinations like DM, MD, MM depending on for which carrier you want the claim to go first.

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If the codes have Billing order D or DD, then the Dental Claims could be generated for them. For generating a Secondary Claim, the Billing Order should be DD. Secondary claims are automatically generated when the primary claim is closed.

When the Primary claim is closed, a waring pop up shows that higher order claims have been created along with an orange toaster.


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Secondary Payments


The real trick with secondary insurance comes when the secondary carrier pays. That's because we can't always forecast what they'll pay since it greatly depends on what the primary carrier has paid.

You are already accustomed to entering three pieces of information for each code in your claim:



In a primary payment, you will adjust the Insurance Expected Responsibility to match what the

carrier paid, so the figures in the Insurance Expected Responsibility field and Insurance Paid field

are the same.

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When it comes to secondary payments, you will use the same fields, BUT instead of copying the amounts directly from the EOB, you'll do some math for the Insurance Expected Responsibility field.

It will be: 

                            Insurance Paid in Primary + Insurance Paid by Secondary


For example:

CareStack will then add the adjustments.


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Here’s what you will do to apply the secondary payment:


1. Select the Add Line Level Payment option.

2. Type the Patient Responsibility from the EOB in the fields as appropriate.

3. Add the amount the primary carrier paid with the amount the secondary carrier paid and type

that total amount in the Insurance Responsibility fields.

4. Type the Insurance Paid from the EOB in the fields as appropriate.

5. Review the adjustment codes CareStack automatically adds.

6. Click Submit when you are ready to apply the payments and adjustments entered for all

procedure codes on the claim.


Frequently Asked Questions


1. The patient's primary insurance claim is paid and closed when the patient tells the practice that they have a Secondary Insurance.

Working with a patient's secondary insurance is relatively simple and automated, driven by the Billing Order. Until and unless the patient fails to tell you that there is a secondary plan until after you've done all the primary work. To bill the secondary insurance that you didn’t even know was there, you are going to  have to undo and redo the primary claim work you’ve already done. It’s frustrating, but not difficult. You are good at all this by now.


First you will have to undo your primary claim work.

  1. In the Insurance Payment module, locate the primary insurance payment.
  2. Select the Reverse Payment tab.
  3. Find and reverse all the transactions for the patient.

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        4. Void the primary claim. We would not be able to change the Billing Order of the codes from D to DD if they already have a claim attached. This is the reason why we void the claim before making changes to the Billing Order of the codes. It isn’t enough to reopen it, you must start over.

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Now we have to make sure that the secondary insurance is Active for the patient. 

  1. Attach the Secondary Insurance to the patient.
  2. Check the Eligibility.
  3. Change the Billing Order of the Codes from D to DD.


Now Redo the Primary work.

            1. Recreate the Primary claim

            2.Change the claim channel to Paper Based. Locate the new claim. Write yourself a note and/or use your practice’s claim flag so everyone understands what happened. Print the claim so it shows as Submitted.

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            3. Apply the primary payment to your recreated claim the same way as before. Close the claim when you are finished.Related image: ./carestack-questions-2023-03-02_files/1628327181286-1628327181286.png

            4. When you close the primary claim again, CareStack will create the secondary claim. Send it on as you normally would.

Written by Athul V Suresh | Last published at: August 08, 2021


Say if insurance paid more than they intended and wants a refund how do we note that in CareStack.


Start by navigating to the Insurance Payments module  (System menu > Insurance Payments).


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1.When the page loads, search for and select the intended receipt on the left side menu, then select the tab titled  Transfer / Refund  at the top of the page.


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2.In the section titled Refund Credits to Insurance (second quadrant), complete the following details:

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3.Decide whether or not to  Print a Refund Check (if so, checkmark this option),  then select  Refund to complete this in the system,  or  Refund and Print to complete this transaction and print a receipt of the same.

This transaction will appear in the  Receipt History tab of the Insurance Receipt details.

The refund check and refund receipt will appear in new, separate tabs to be printed and/or downloaded.

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Refund Receipt

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Refund Check Printing

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To be able to print checks you will need to enable the print check options as ‘yes’ inside Practice settings > Payments > general > Payment services > banking details and fill in the required details.

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Reverse Refund

To reverse a refund navigate to:

  1. Transfer / Refund tab of the Insurance Receipt details, checkmark the intended refund transaction (pictured above).
  2.  Select  Reverse Refund

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The dollar amount that was refunded will become Available Credits that can be reapplied.

Written by Abhishek Vijay | Last published at: August 08, 2021


Oops! Did you make a mistake while creating an insurance receipt? No need to worry at all, as we are able to delete an insurance receipt added.

You can delete a payment, but all the work you've done will be reversed. You will need to re-open the claims to apply the receipt towards another payment.

To delete an insurance payment:


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Permissions 

There you go! Nobody else will know of your mistake. Not unless they look through the Audit Trail that is. Once a receipt has been added or deleted, it would show up under the Audit Trail as demonstrated below.

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Written by Aswathy B Nair | Last published at: August 08, 2021


Oops! Made an error while posting an insurance payment? Don't worry, you can easily undo all payments and adjustments posted against the claim, and the claim will be reopened for you to post again. This can be done right from the insurance payments page, without having to navigate to the patient's ledger.

The Permissions to Reverse Insurance payments is set under System Menu > Practice Settings > Administration > Profile > Billing


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How do we reverse an insurance payment


          


What happens when we reverse a payment?


Note:

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Written by Rinu Seba Joemon | Last published at: August 08, 2021


By this time you would have learned how to add a new insurance payment. Once a new payment has been added to the insurance payments page a receipt would be created. A tab that is included in the insurance receipt is the ‘Receipt History’. As the name suggests the receipt history tab shows all the transactions that were completed under this receipt. Let’s take a look at this.

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Written by Rahul Krishnan | Last published at: August 22, 2021


Insurance is a contract, represented by a policy, in which an individual or entity receives financial protection or reimbursement against losses from an insurance company. The company pools clients' risks to make payments more affordable for the insured.


There are a multitude of different types of insurance policies available, and virtually any individual or business can find an insurance company willing to insure them—for a price. The most common types of personal insurance policies are auto, health, homeowners, and life. Most individuals in the United States have at least one of these types of insurance, and car insurance is required by law.


Overview of Dental Insurance


A dental insurance company plan helps to cover the costs of preventative dental care while softening the blow on pricier dental procedures like crowns, bridges, and fillings. First, here’s a breakdown of how individual dental insurance works. You select a plan based on the providers (dentists) you want to be able to visit and what you can afford to pay. The monthly premiums will depend on the insurance company, your location, and the plan you choose.

Most dental insurance plans have a waiting period during which major procedures are not covered for a year after the plan begins, with minor ones not covered for three months. If you’re thinking that you’ll just hold out and purchase dental insurance when you need it, think again. Because of what’s called a waiting or probationary period, this strategy won’t work (you didn’t really think you’d found a way to outsmart the insurance companies, did you?). Waiting periods mean that, for example, one year after you first become insured, your insurance will not cover any major work (such as crowns or root canals) and for three months after you first become insured, it won’t pay for any minor work (such as fillings). Waiting periods vary by policy.

It is not necessary that the patient always has dental insurance. He/she can also have medical insurance that may cover certain dental codes as well. A patient can also have both medical as well as dental insurance. When a patient has multiple insurance plans, one will be the primary and the remaining will be the secondary/tertiary insurance.

Any insurance plan will have a subscriber who is the person who holds the contract for the plan with the carrier. The subscriber pays the premium to the carrier in exchange for coverage for members as described in the plan. (The subscriber should not be confused with the RP who is the person who is in charge of the patient not only for the bill, but for treatment decisions, communication, statements, and coordination efforts.) However both the RP and the subscriber can be the same person or they can be different persons as well.


Exploring Patient Insurance

The Patient Insurance page in CareStack has everything you ever wanted to know about the patient insurance plan, organized into tree structures. You can easily navigate to the page using the Insurance icon or with the different insurance links on the Patient Overview. The insurance page gives you detailed information about the patient and their account's insurance,  past and present. By default, the insurance tab shows the insurance of all the account members in a tree structure and it hides the terminated insurance plan that was previously added for the account members.

By selecting the 2 checkboxes on the top, you can choose to view only the current patient’s insurances as well as view the terminated insurance plans.

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Attach Insurance

Attaching insurance to the patient's profile is the first link in the critical insurance chain. CareStack associates detailed insurance plan records with the patient so you have complete, accurate treatment estimates that reflect the member patient's current relationship with the insurance plan.

To add a new insurance for a patient, one can navigate to the Insurance tab from the Patient Overview and click on Add Insurance on the top right.

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On clicking the Add button, the landing page will look something like this.

Related image: ./carestack-questions-2023-03-02_files/1628595378784-1628595378784.pngYou will be able to view the RP and other members in the account on top and the same members will be listed out in the bottom too. If you wish to add a new member to be a part of this account, you can click on Add Another Member which will take you to the Create New Patient landing page.

The first step involved in attaching an insurance for a patient is to choose the subscriber. We’ve already defined Subscriber as the person that holds the contract for the plan with the carrier. CareStack lets you choose between 3 options. 

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1.Same as RP: The same person that is financially responsible for THIS patient (Responsible Party) can be the subscriber. This would be the default setting that is selected.

2.Select from existingA person that is NOT THIS patient's responsible party, but is in your database as a patient. You can select any other patient from the existing database of patients. When you select a patient, you can select any of the plans that are attached to that patient’s insurance for your current patient by choosing Use Subscriber’s insurance. If the new patient does not have any existing plan, then they would have to add a new plan for the subscriber as it is mandatory. To add a new plan for the subscriber, you can select the option Add New Plan to subscriber. If the new patient does not have any existing plan, then they would have to add a new plan for the subscriber as it is mandatory.

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3.Add New: You can add a brand new person not yet in your database as the subscriber. Please note that by doing so, you are actually creating a new subscriber who is not a patient. A person who is subscriber only will only have the insurance tab in his patient overview screen. There won’t be any other tabs like Clinical, Medical History Forms, etc which are exclusively meant for patients. However, you can always convert a subscriber who is a non-patient to a patient. Shown below is one such subscriber who has been created and is not a patient.

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After the subscriber has been chosen, you will have to enter a Subscriber ID type which is like a unique identification number provided for each of the subscriber. You can choose either a subscriber ID or your SSN number as the subscriber Identity number. The subscriber ID number will be present in the subscriber’s insurance card and the SSN number is the Social Security Number which exists for every citizen in the United States. Any one of them is mandatory. After choosing the ID, then the effective date has to be chosen after which the insurance plan will be active.

Attach a Plan

With the subscriber element out of the way, we are ready to focus on attaching the plan. Locate or add details for your pan. Depending on what you know and what you are ready to commit to, you have three options:

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  a) Find a plan you already have in your database by typing the group or plan no in the plan field by searching the drop     down lists.

  b) Typing what you know in the draft fields so you have the details without the commitment 

  c)  Add a new carrier or plan to your database.

When you select a particular employer/carrier, all the plans linked to those plans or employer will show up.

After the plan has been added, you can now associate the plan with other members of the patient’s family. You can select any other patient from the account that need to be added under the same plan and set their relationship to the subscriber. The subscriber will be selected by default.

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If you have identified and selected the right plan for the right patient and has completed all the mandatory fields, you proceed to verify the plan. Please note that verified  plans are fully associated with the patient and cannot be removed or deleted. 

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If you do not have all the details at the moment say the plan details or the employer details, you can enter the other details that you can fill right now and save the plan without selecting the Mark Insurance as Verified checkbox. This will save the insurance in the Draft status with the details you have entered so far. Once you have the complete information, you can complete entering the remaining details and mark the plan as verified. 

  An insurance that has been saved without marking it as verified will be in the draft status as you can see in the screenshot below.

Related image: ./carestack-questions-2023-03-02_files/1628597271371-1628597271371.pngInsurance that are still in the draft status can be deleted but those which have been marked as verified cannot be deleted.


Different Insurance statuses


1.Active: When the insurance is saved after marking it as verified, it will be active if the effective date is reached. However it will be still showing an eligibility pending status in red. Also if the hierarchy has not been set for a plan, that too will be displayed in red(when multiple plans are added for a patient). 

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The hierarchy can be set by clicking on the Hierarchy Assignments on top right next to the add button. From here, you can define if an insurance plan is primary/secondary insurance if a patient has multiple insurance plans. You can add any number of insurance plans for a patient but you will be able to set the hierarchy only upto the tertiary insurance. So in effect, at a time, a patient can have at most a primary, a secondary and a tertiary plan in CareStack.

Shown below is the hierarchy of a patient with 4 insurance plans but the hierarchy is defined only for 3 of them.

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A plan is active and the eligibility updated when you have checked the patient's eligibility under the plan  and have the coverage details. You will have to edit the Benefits by opening the plan and then save and update eligibility.

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Once this is done, the insurance plan will show as eligibility updated.

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2.Inactive: An insurance plan whose active date has not yet been reached will be shown as Inactive. An insurance plan whose active date has been reached but if an additional waiting period has been defined for the plan and the effective date is not yet reached, the insurance plan will be displayed as inactive too. Such plans will be active once the active date or effective date is reached.

Related image: ./carestack-questions-2023-03-02_files/1628598532459-1628598532459.png3. Draft-Draft plans contain incomplete details used as a placeholder until they can be  matched or completed. With this option, you can begin a draft insurance plan with whatever  information you do have. When you have the rest, you can complete and verify the plan, or  discard your draft. To delete a draft insurance plan, you can click on Delete.

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4.Terminated- An insurance plan which has been saved after marking as verified cannot be deleted. However any active insurance plan can be terminated by updating the termination date. The termination date is like the expiry date of the insurance plan and if that date is reached, insurance is no longer active. The termination date of any insurance plan can be seen next to the plan name along with the effective date. If no termination date has been set for a plan, it will show as Indefinite. However, you can always change the termination date of an active insurance. If you wish to terminate an insurance which is active right now, you can click on Update Termination Date and set the termination date to a past date after which the insurance plan will be termed/terminated.

Related image: ./carestack-questions-2023-03-02_files/1628599067972-1628599067972.pngThe termination date can only be updated if an insurance plan is active. There will not be an option to update the termination date for an inactive plan. Shown below is an inactive plan for which there is no option to update termination date.

Related image: ./carestack-questions-2023-03-02_files/1628599108422-1628599108422.pngBy default, the terminated insurances of a patient are hidden. You can view them by ticking the Show Terminated Plan checkbox on the top which will display the terminated plans for a patient.

5.Pending verification- An insurance plan in the pending verification status indicates that the benefits associated with the insurance plan have not been updated. On opening the plan details and updating the plan benefits for a patient, one can click on Save and update Eligibility and the plan will no longer be in this status.

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Written by Geo Thomas | Last published at: August 19, 2021


Here in this article, credit transfers refer to the transfer of money(credits) from an insurance receipt to the patient’s account. When, why and how does such a thing happen?


When?: This usually happens when the insurance overpays. If the amount the insurance paid is more than the actual fee of the code, the remaining amount is either refunded to the insurance or transferred to the patient’s account as unapplied credits. 


Why?: The amount paid by the insurance is actually the patient’s money. If the insurance pays and the practice does not use it, the patient loses the money, and it would also mess up their end-of-the-day reports.


How?: In CareStack, this is done by the creation of Transfer Receipts. CareStack automatically creates transfer receipts in the situation mentioned above.


Even though the idea behind transfer receipts is good, the creation of a transfer receipt is not much appreciated. The reason behind this is that such receipts are created from another receipt and not an actual payment source. Hence, this would also mess up reports. Insurance payments are therefore posted in such a way that transfer receipts are not generated. This is done by adding adjustments to the codes for which there are chances of creation of transfer credits.


Example of creation of transfer credits


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These credits would show up as a transfer receipt under Billing > Payments > All Payments

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Deletion of a transfer receipt


To delete a transfer receipt, select the receipt and then click Delete.


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This would not only delete the receipt, but also reverse all the transactions done on it.


Upon checking the Insurance Payments section under the System Menu, the receipt would have this amount credited back to it.


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Required Permissions


The minimum permissions required for the above operations are as in this image.


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Written by Mathew Kandirickal | Last published at: August 15, 2021


Provider Adjustments


Provider adjustments are basically not associated with a production or procedure code that was completed or claimed.


You can find the Provider adjustment option by navigating to System Menu > Insurance Payments > Select the Receipt > Check the 'Show Provider Adj. Options'.


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The provider adjustment consist of 5 tabs :


Consider this example :-

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When the user click on the submit button, the $200 is going to be deducted from the receipt and is tagged against the provider.

The following will appear in the receipt history :

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Reversal


If the added adjustment needs to be reversed, the user can navigate to the Reverse Payment tab > Select the adjustment > Reverse.

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Written by Abhishek Vijay | Last published at: January 03, 2022


What is an ERA?

An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations. The explanations include the denial codes and the descriptions, which is present at the bottom of ERA. ERA is provided by plans to Providers.

EDI Health Care Claim Payment/Advice Transaction Set (835): is the specific code number for making claim payments and sending the explanation of benefits remittance advice.

ERAs are sent from the payor (insurance carrier) to the payee (the practice/provider) and the system maps the information received to the data in CareStack via a Parsing EDI process. Parsing an EDI, means to map all the segments in an EDI transaction file and uniquely mapping it to a segment in the corresponding file format.

Once the ERAs are parsed the same will be available in the left pane/ERA Slide out.

The Pending Posting section contains the ERAs which have not yet been posted.

The Posted section contains the ERAs which have been completely posted. 


ERA Details


*The ERA Details of a selected ERA, is available from the right pane of the Electronic Remittance screen.

The Electronic Remittance Screen in CareStack


An insurance posting agent can navigate to the Electronic Remittance section by navigating to System Menu > Electronic Remittance.

The Electronic Remittance screen consists of two tabs:

1.      Electronic Remittance Advice

2.      Preauthorization Remittance

 

Electronic Remittance Advice

The left pane/slide out consists of the ERAs sent to the practice from the payor. 

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This provides the information such as: 

The Search box works by filtering the responses with the Carrier Name as the search criteria.

The insurance posting agent is also provided with an Advanced Search option, which will allow the insurance posting agent to search using more specific details and specific criteria. 


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The Claims Payments section consists of the responses made by the carrier against a claim.

Upon opening the claim accordion, the details such as the patient info, procedure info and charge lines detailing the procedure and the fee/adjustments are available.

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How to post an insurance payment from an ERA?

1.      Add Payment using the ERA response. 

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2.  Enter the required details like creating a receipt from the Insurance Payment screen. (**The Carrier Name and Payment Amount are disabled as this information is taken from the response)

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Once a receipt is created, the Receipt # is shown and the same can be accessed from the Insurance Payment screen. 

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3. 

a.  If a claim has been mapped correctly to a patient/claim in CareStack, (i.e. no parsing errors) then the payment can be posted from the claim like the Insurance Payments screen. 

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The insurance posting agent can proceed with ‘Paid as Expected’, ‘Add Claim Level Payment’, ‘Add Line level Payment’ or ‘Mark as Denied’.

b.  ** If the claim has not been mapped properly (i.e., Parsing Errors are present), the claim response status would be in ‘Needs Attention’.  If this is the case, the insurance posting agent can manually select a Patient and corresponding claim inside CareStack and link it to the same. This would change the status from ‘Needs Attention’ to ‘Pending Posting’.

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4.  Once the claim has been linked/mapped, the insurance posting agent proceeds with the payment options available, and once the linked/mapped claim is in ‘Closed’ status, the status of the Claim Response will be changed to ‘Posted’. 

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Provider Adjustments

The Provider Adjustments section allows the insurance posting agent to credit some or the complete insurance payment against a provider. This is useful in cases where the Insurance may overpay due to being late in remitting the payment and the practice prefers crediting it to the provider instead of the patient.

How to link a Provider Level Adjustment to a claim in CareStack? 

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The insurance posting agent can proceed to another action or delink the claim, which will reverse the provider level adjustment, reinstate the credits, and unlink the claim. 

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Pre-authorization Remittance


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The insurance posting agent can select an ERA Response from the slide out and proceed with completing the Pre-Auth Response (i.e., Submitting the coverage information – Covered/Not Covered).

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Like the Electronic Remittance Advice – Claim Payments, the insurance posting agent can either have a parsed/mapped pre-authorization response. 

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The completed pre-authorization response would be shown below.


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Once a pre-authorization response has been submitted from the ERA screen, the response section of the pre-authorization screen shows the response.  

Profile Permissions for Using ERA

The Super Admin can provide permissions to different user profiles to access the ERA information at different levels. The same can be managed from System Menu > Practice Settings > Administrations > Profiles > Manage Permission > Billing > ERA.

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Advantages of Using ERA

 

What is the difference between EDI & EFT?

Electronic data interchange (EDI), or electronic data processing, is the electronic transmission of data between computers in a standard, structured format. 

Electronic funds transfer (EFT) is the term used for EDI that involves the transfer of funds between financial institutions.

ERA Auto-posting



CareStack provides the users with a built-in functionality of ERA Auto-posting, which is provided only by a few other competitors. The ERA contains all the information with regards to the insurance payment made against a claim. Since this is available, CareStack processes the information and posts/submits the payment against the claim to which it has been mapped. This allows the practice’s insurance posting flow to be automated efficiently and saves time and manpower.

The user is provided with the same functionalities available while posting manually from the Insurance payments screen. But the auto-posting functionality automates the process to save the hassle for the user.

How to enable ERA Auto-posting?

1.       Navigate to System Menu > Practice Settings > Payments > Insurance Payments > ERA Posting.

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2.       Enable the ‘Auto-post ERAs when available’ by setting it as ‘Yes’.

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3.       A central billing office user (generally) can also set the Auto-Posting preferences.

a.  Do not Auto-post ERAs with Payment Type: Enables the user to discard ERAs with the selected payment types, from the Auto-Posting flow.

b.  Default Payment Type for Check

c.  Default Payment Type for Direct Transfer  

d.  Auto-Adjust at Claim Level: Allows the user to customise the adjustments added while auto-posting the payment amounts based on the ERA amounts, while posting claim level payments.

e.  Auto-Adjust at Line Level: Allows the user to customise the adjustments added while auto-posting the payment amounts based on the ERA amounts, while posting line level payments.

4.  Hit ‘Save’ and you are ready to go.

**The adjustments added while auto-posting ERAs are the system adjustments which are available at System Menu > Practice Settings > Codes > Adjustment Codes > System Adjustments

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How does CareStack post the ERA automatically?

Before moving onto the ERA auto-posting process, let’s discuss the statuses available to an ERA.

1.  Pending Auto-posting: If ‘Auto-post ERAs when available’ is set as ‘Yes’, then the ERAs parsed are changed to this status by the E-Claim submission Job. ERAs having these statuses are not available to the user in the UI and are made available in the UI only after the Auto-posting job has been completed.

a.       Creates an insurance receipt.

b.       The ERA auto posting job picks up each claim response and then posts the payment accordingly (add adjustments if any)

c.       Once the job is completed, it is sent either to the Pending Posting section or Posted section as per the status.

2.  Pending Posting: ERAs parsed correctly without any errors are made available to the user for manual posting from the System Menu > Electronic Remittance > Electronic Remittance Advice > Claim Payments tab of an ERA.
    - This status also has the ERAs which have been Partially Posted.


3.  Posted: If an ERA has been posted completely (either via manual or auto-posting flow), i.e., if all the claims mapped against the ERA are in Posted status, then the ERA would be available in the Posted section of the slide-out.

Since we have a clear picture of the statuses regarding ERA Auto-Posting flow, let us discuss the jobs with regards to ERA auto – posting and how the process works.


E-Claim Jobs

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ERA Auto-posting

Auto Posting History shows the list of auto-posting batches happened from the PMS. Details such as Batch#, Carrier Name, Check # / EFT Trace #, Receipt, Amount, Date of Posting, User, Status.

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Written by Revati Krishnan | Last published at: August 19, 2022


Detailed Document on Ortho Payment Plans


Orthodontic Billing 

Introduced 2 workflows for orthodontic billing:

  1. Case level - Payment plans are created based on the case details. Here the ortho payment plans are dependent on the ortho case.
  2. Plan level - New workflow where the user is given the flexibility to change the payment plan details irrespective of the case information. Here the ortho payment plans are independent of the ortho case.

This is an account level configuration a practice can set according to their requirement.

Add a Case

Orthodontic cases provide the structure for the clinical and billing elements of the patient’s orthodontic treatment. Remember that a patient may have multiple cases that represent different parts of the overall treatment. Before you begin, there are a few things you’ll need: 

1. Click the Add Case button.


2. Complete the fields as appropriate for your case:

3. Click Save.

Clinical Elements

The Ortho Console includes several clinical elements to provide more details about the treatment.

Treatment Objective:

A Treatment Objective is a way for the orthodontist to describe the treatment for the case outside of the context of ADA codes. After all, a code is just two sentences of general description.

To add a treatment objective:

1. Click Add Tx Objective.

2. Type the objective, tapping Enter to save.

Visit Summary

A Visit Summary is a free-form description of an appointment that can be used to provide findings and additional details. You might appreciate being able to type notes outside of the Care Note function.

To add a visit summary

1. Click Add Visit.

2. Type the Details

3. Click Save.

Clinical Notes 

Having the clinical notes visible in the chart and in the orthodontic case makes it easy for the provider to review previous notes and to add new ones using CareStack's Care Note tool. Your practice will design your notes with the appropriate questions and prompts.

To add a note:

1. Click Add Note

2. Select the Care Note template from your practice's list and click Add Note.

3. Complete the Care Note as appropriate.

4. Click Finalize or Save as Draft.

Orthodontic Billing - For Insurance

The Insurance Payment Plan connects all the elements of the case with the details of how the patient's insurance carrier will cover its portion of the cost of the treatment. For each of these tasks, you’ll begin on the Payment Plans tab of the ortho console. 

Before You Begin

Before you begin entering the payment plan, there are a few things you’ll need to do to prepare. First, gather the details of the patient’s insurance benefits and orthodontic coverage from the patient’s insurance eligibility page: 

Since you cannot change the case details once the payment plan is created, be sure to confirm your case details, especially the dates and amounts which are important for claims. 

To build out the insurance payment plan, you'll need these details: 

Add an Insurance Payment Plan 

Now, build the plan with these details. To add an insurance payment plan: 

1. Switch to the Payment Plans tab if required. 

2. Click Add Insurance Plan 

3. Complete the details for the payment plan.

4. Click Save or Save and Print. This saves the payment plan in draft.

5. Now click on Start to activate the payment plan.

CareStack uses this information to build the billing schedule for those periodic payments. 

Initial/Periodic Billing 

View the payment schedule by clicking the View/Update Schedule link on the payment plan summary. 

Edit a Plan

You carefully built your insurance payment plan so the insurance carrier would pay the initial payment and each periodic payment after that until the treatment was paid for. But things happen and sometimes you'll need to change or give up on a plan.

You would edit an insurance payment plan to change the number of payments or the treatment amount. To edit an insurance payment plan:

1. Switch to the Payment Plans tab if required.

2. Click Edit.

3. Update the relevant the details for the payment plan. Though it looks like you can change the plan, you should terminate the plan and create a new one for the new carrier.

4. Click Save.

Terminate a Plan

You would terminate an insurance payment plan to change carriers, or if the patient is discontinuing treatment. 

When you terminate a plan, you must decide what to do with the remaining scheduled payments. Your options are: 

To terminate an insurance payment plan:

1. Switch to the Payment Plans tab if required.

2. Click Terminate.

3. Add the Termination Date and click Continue.

4. Select how you will handle the remaining balance.

5. Click Terminate.

The plan will remain on the Payment Plans Tab with the Terminated label. You can still review the details and original payment schedule.

 Orthodontic Billing - For Patient

The Patient Payment Plan connects all the elements of the case with the details of how the patient's insurance carrier will cover its portion of the cost of the treatment.

Before You Begin

Before you begin entering the payment plan, there are a few things you’ll need to do to prepare. Since you cannot change the case details once the payment plan is created, be sure to confirm your case details, especially the dates and amounts which are important for claims.

To build out the patient payment plan, you'll need these details:


Add a Patient Payment Plan

Now, build the plan with these details. To add a patient payment plan:

1. Switch to the Payment Plans tab if required.

2. Click Add Patient Plan.

3. Complete the details for the payment plan.

4. Click Save or Save and Print.

CareStack takes this information and builds the billing schedule for those periodic payments.

Periodic Billing 

View the periodic schedule by clicking the View/Update Periodic Billing Details link on the payment plan. 

Once the billing structure is in place, you still might need to work with it. For example, if the patient might need to skip one of the planned payments. To skip a payment: 

1. Open the Periodic Billing Details. 

2. Place a check mark beside the payment to be skipped. 

3. Click Save. 

CareStack will recalculate the remaining payments to incorporate the missed payment. If the patient is taking a break from treatment, you can pause the payment plan: 

1. Click Pause 

2. Review the schedule and click Pause.

When you are ready to resume the plan, click Resume and confirm. CareStack will recalculate the remaining payments.

Edit a Plan

You carefully built your patient payment plan so the patient would pay the initial payment and each periodic payment after that until the treatment was paid for. But things happen and sometimes you'll need to change or give up on a plan.

You would edit a patient payment plan to change the number of payments or the treatment amount. To edit a patient payment plan:

1. Switch to the Payment Plans tab if required.

2. Click Edit.

3. Update the relevant the details for the payment plan. You will only be able the change the patient total and the number of terms.

4. Click Save.

Terminate a Plan

You would terminate a patient payment plan to change carriers, or if the patient is discontinuing treatment. When you terminate a plan, you must decide what to do with the remaining scheduled payments. Your options are:

To terminate a patient payment plan:

1. Switch to the Payment Plans tab if required.

2. Click Terminate.

3. Add the Termination Date and click Continue.

4. Select how you will handle the remaining balance.

5. Click Terminate.

The plan will remain on the Payment Plans Tab with the Terminated label. You can still review the details and original payment schedule.

Written by Mathew Kandirickal | Last published at: August 14, 2021


Sometimes patients just don’t pay their bills. The Practice tried. They prepared the treatment plan with the estimates and accepted payments when they could. They sent letter after letter. Maybe they even made a payment plan arrangement, but the patient still can’t or won’t pay. When the practice is ready to quit and pass the work over to a professional Collection agency. CareStack can help with that part too.

Collection Agencies


The user need to setup a Collection Agency, the professional organization that can collect debts on their behalf, usually for a fee. They will find these settings in Practice Settings -> Collection Agency.

To add an agency:

1. Click Add.

2. Complete the details for the agency.

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3. Click Save or Save and Continue to add an individual contact person to the agency.


Patient Profile

Once the practice has decided to throw in the towel and pass the patient on to a collection agency, they would want to set the patient flag, or label, to show they’ve been sent to collections:

1. On the Patient Overview, click the Edit Labels link.

2. Select Sent to Collections.

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Permissions

The user would require the following permissions for the above mentioned.

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Collection Payments


Once the practice send the patient details off to the collection agency, they wait. With any luck, that agency will be able to collect something from the patient. When they do, they’ll send the funds and a statement. The user would have to enter the payment into CareStack and show how it should be allocated to the patient. Sound familiar? It’s a lot like the work they do with insurance payments.

Add a Collection Payment

It's important to capture the key details that identify the payment and transactions. We’ll start at the Collection Payments module. System Menu -> Collection Payments.

1. Select the Collection Agency from the drop-down list.

2. Enter the payment details, including the Payment amount, Date, Location, Payment Type and Remarks pertaining to this payment.

3. Click Apply or Save.

On the right side we can see the Collection agency details including -  Total No of Payment, Paid Till Date, Applied Till Date, Unapplied Credits, Last Payment Date.


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The Location will be populated from the current location shown in the upper right corner by the system menu. We can change it from the drop-down list. Many practices enter the date from the check or statement as the Payment date. The  practice’s guidelines can be followed here.

Some Payment Types need a reference. The field will appear when required. The new payment will be ready for to apply to the profiles. The list of payments and the receipt details will be found on the left side of the screen.


Apply Collection Payment

Now we can apply the collection payment to the patient accounts. With the payment selected:

1. Select the Patient from the drop-down list. ONLY patients whose accounts have the “Sent to Collections” flag will appear.

2. Click Search to display a list of the codes the patient still owes a balance on. If desired, narrow the codes by date or provider.

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3. Enter the details provided by the collection agency about what was paid to the practice and what was held as commission.

4. Click Apply when you are finished.

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When the user clicks on Apply a warning message will pop up asking the user whether they want to remove the label Sent to Collection from the patient. They can click Yes or No.

Adjustments

If the user is willing to accept the payment from the collection agency as the final word on the patient’s balance, they can write-off the remaining amount with an adjustment directly in collections window:

1. Click the More link under the Adjustments column for the code line.

2. Select the Adjustment Code used by the practice and enter the amount.

3. Click Apply.

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Note:

After applying the above mentioned payment, the following will appear in the patient ledger :

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Permissions

The user would require the following permissions for the above mentioned.

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Written by Rinu Seba Joemon | Last published at: August 31, 2022


Statements

Generation Criteria

Statements can be generated for an individual patient and an account. An account is a group of patients that share a common responsible party. Statements are addressed to the responsible party of the group. Users have the privilege to set default values in Practice Settings > Payments > Statements > Generation Criteria. Based on the values set there, the values would get populated by default while generating statements.

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Accounts for Generation

Region: This criterion is used to define the location where the statement needs to be generated. It would be All by default. Statements are generated for an account if the mentioned location(s) matches with the default location of the responsible party in the account.

 Location: This criterion is used to define the location where the statement needs to be generated. It would be All by default. Statements are generated for an account if the mentioned location(s) matches with the default location of the responsible party in the account. 

Generate Statements for:  This criterion is used to define the accounts in the system that needs to be considered during statement generation. There are 3 choices:

  1. All: Considers all the accounts in the system
  2. Custom: Generates statements for accounts depending on the Last name’s starting letter of the responsible party of the account. Users can choose the alphabet period. (For example, if A to E is selected, all accounts whose responsible party last name starts with letters between A and E (both inclusive) would be considered during statement generation
  3. Individual Account: Generates statement for a single account, whose responsible party was chosen from the drop-down

Generate for Patients of Type: A user can choose the account type of patients for whom statements should be generated for like General and ortho.

Generate for: The user can choose the 'Generate for' option to choose for whom all the statements should be generated. There are 3 choices

  1. All Patients
  2. Patients sent to Collection Agency Only
  3. All Patients except those sent to Collection Agency.

Generate for Accounts with: A user can choose the accounts for which the statements could be generated. There are 3 options.

  1. Both Patient and Insurance Balance
  2. Patient Balance Only
  3. Insurance Balance Only

Generate for Patients with Labels: A user can choose the labels so that the statements would be generated for patients who have specific labels. The dropdown shows all the patient labels.

Minimum Account Balance to Generate:


Exclude Statement Generation for:

Setting the above options to Yes, would exclude statement generation for the corresponding patient/ accounts.


Generation Period


  1.  Last Statement Date: Considers entries from the time statement were last generated for that account.
  2. Custom: Consider entries from the mentioned date. Future dates would be blocked from the corresponding date picker 

_________________________________________________________________

Statement Notes


Dunning Message: 


Statement dunning is a process of gradually reminding patients about their overdue balances as they "age".  If you would like to include dunning messages,  select  Yes,  then select the note template you would like to use for each aging bucket (0-30 days, 31-60 days, 61-90 days, and 90+ days).


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Template Settings

Group Transactions by Patient



Generate separate Statements for Ortho Patients:  This is set to Yes would generate separate statements for Ortho patients in the account. 


For example: If Patient A, B, and C have the same responsible party D, and if patients B and C are ortho patients and A and D general patients, then if statements are generated with this option set as Yes, 3 statements would be generated for this account, all addressed to D. One for D and A (general patient) and one each for B and C. There 3 statements would be 3 individual statements and would and the entries would be printed on separate statements.


Print Aging Summary: This option determines whether or not the Aging Summary has to be printed on statements. There are 4 options:


Print Payment Plan SummaryThis option determines whether or not the Payment Plan Summary has to be printed on statements. This grid would be hidden from the print if the account has no payment plans. There are 4 options:


Print Location Level Summary: This option determines whether or not the Location Level Summary has to be printed on statements. 


Print Previous Balance Summary: This option determines whether or not the Previous Balance Summary has to be printed on statements. 

 _________________________ 

When you are finished entering your statement criteria, click   Generate at the bottom-right of the screen.

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Review Your Batch Statements

Review your new batch of statements by clicking on its record listed on the left side panel.

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Take Actions on the Statements


Exclude:  If a patient had a statement generated and you do not want to send it to them, you can toggle the same in the  the Exclude column. 

Status History: The info button in the status column, shows a timeline of the status history of the statement. 

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Action

Print: The print button allows the user to print the statement.
Void: The void button allows the user to void an individual statement. If the batch was generated on accident or with incorrect generation criteria. 


The user will also be able to do the same for multiple statements, once the user selects the statements and proceeds with doing the same actions available on the top right of the grid.

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Send The user will be able to send the batch of statements to your patients, via the Printing & Mailing Service, if they have enabled the 'Use Printing and Mailing Service' as 'Yes' (Practice Settings > Payments > Statements > Other Settings). Related image: ./carestack-questions-2023-03-02_files/1638119758190-1638119758190.png 

______________________________________________________________

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The header provides the batch level information and also helps the user download the additional data regarding the batch statement generation : Generation Criteria and Exclusion List.

-  If nothing happens when you click to download the statement, or when hitting the Print icon, you may have a Pop-Up Blocker.

Generating a statement from a patient profile:

To generate statements from a patient profile you may navigate to the Patient's Billing > Statements / Patient's overview > Click on the Print icon > In the window that slides open > Set time period for printing clinical and billing-related items > Select Statements > You could also tickmark on Include Account Statements if you would like to view the whole account statements > Click on Print.

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Upon navigating to the same, all of the patient's statement will be shown in a grid similar to the Batch statements screen. 

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The 'Generate New Statement' allows the user to generate a new statement for the patient. A set of generation criteria specific to individual statements will be shown where the user will be able to generate a statement for a specific account.

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The user could proceed with generating a statement based on the criteria selected. 

Practice Settings

The user can edit three different categories of settings with regards to statements.

1) Template

Template Type: The user can select the template type they want and set the same default, by clicking on the 'Set as Default' button. 

Related image: ./carestack-questions-2023-03-02_files/1638123945399-1638123945399.pngUpon selecting the same, the user will be able to edit the template general settings.

Name of Billing Entity : The user can enter the name of billing entity to be printed on the statements.

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The options available for setting the Address (Return & Remittance) to be Printed are Account Address, Location Address, Brand Address (if enabled) and provision of a Custom address. 

In the case of Advanced Template, the user can enter a General Message to be shown on the statement. This can be a general help text the user can set.  

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2) Generation Criteria

The user can set the default generation criteria they would want to have throughout the PMS, in the 'Generation Criteria'  tab. The criteria have the same impact as the one in the batch generation context and patient generation context.

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3) Other Settings

The ancillary settings regarding statements and the postal service are provided under the 'Other Settings' tab.

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Statement Templates 

The different types of templates available are Standard Template, Print & Mail Service Template & Advanced Template (new)

Standard Template

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Print & Mail Service Template



Advanced Template

That is all about statements. Take a look at this by yourself!

Written by Aaqib Mohammed Sali | Last published at: August 15, 2021


Overview


Insurance Claims are an essential part of your billing process. This is your way of requesting payment from insurance carriers for the care you have given and the treatments you have performed. CareStack has several tools dedicated to the claims process so that you can easily create, transmit, and track them. 


Explore the Claims Module


In the centralized Claims module, you are free from the context of an individual patient. In this global view, you can: 

Launch the Claims module from the System Menu.


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Claim Tabs

The claims module covers everything you ever wanted to know about your claims but were afraid to ask. The tabs in the module filter and display different categories of claims. 


Column Headers

Even with the segmented tabs that group claims of a specific status, you may need to target your work even further. Narrow down your listed claims by choosing some filters. 

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Most frequently, you'll use these to:

You can use a combination of filters too. For example, on the pending payment tab, you might choose one location and one carrier. Besides filters, many of the column headers can be used to sort the list in ascending or descending order.


Digging Deeper


With those sort and filter options, you can easily find the information you need about sets of claims that meet the criteria. But how do you learn more once you've found the claim? 

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Click within the claim’s row to open the details of a specific claim 

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Generate a Single Claim


You have two different options for generating your insurance claims within CareStack, individually or in batches. Let’s start simply with the individual claim. 

You can easily create an individual claim by selecting the treatments to be included, either in the appointment or in the chart.

Whichever place you choose, to create a single claim:

  1. Select the treatment(s) that should be part of the claim. Please note that the billing order for those treatments should be D or DD to bill to the carrier.
  2. Right-click beside the treatments to open the pop-up menu. 
  3. Select Create Claim.
  4. Confirm by clicking Ok.    

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Generate Batch Claims


Imagine going the whole day working with your patients, but not doing anything with claims as you complete treatments or close-out appointments. 

As the day winds up, you tell CareStack to review all the appointments, charges, and insurance information to create every claim all at once. You just decide when to kick off the process and what Date of Service to use. To kick off the batch, start at the Claims module, on the Batch Claims tab.

  1. Click Generate Batch Claims.
  2. Complete the details for the batch.
  3. Click Generate.    

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When we say to complete the details for the batch, we are saying to describe the claims you want CareStack to create for you: 

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Get Claims Out the Door


The carriers can't pay if the claim sits in your printer tray. Once they are generated, you need to get the claims out the door, either in envelopes or through cyberspace. Just as with creating the claims in a batch, the easiest way to get the claims out the door is to transmit them all at once. 

We'll do that from the Claims module on the Pending Payment tab. 

  1. Click Transmit All Claims.
  2. Click Ok on the confirmation message.  

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CareStack even saves you from yourself by NOT sending the claims that have errors, even if they are included in the category of “All”.

If you do want to pick and choose which claims are sent or printed. You can do that too. 

  1. Select the claim(s) you want to send. 
  2. Click Actions
  3. Select Transmit Selected Claims or Print Selected Claims

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Resolving Errors


When a generated claim has an error or issue that needs attention, CareStack flags that claim as Saved With Errors

While CareStack won't catch every potential issue that could cause the claim to be rejected, it will catch common errors from missing information, mismatched providers, and incomplete fields. To correct an error: 

1. Click the claim row to open it. 

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2. CareStack will identify the error at the top of the claim form. Correct the error by completing the missing field or updating the information. The patient or provider profile won’t change, but you will be able to submit the claim. 

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3. When you have corrected the error, click Save, Submit, or Print & Submit as appropriate. 


Claims with Attachments


Many carriers require you to include attachments with your claims, but nobody wants documents flying back and forth through cyberspace. NEA Fast-Attach is a separate service that allows you to include the attachments the carriers want when you submit claims and authorizations using CareStack.

You will need to log into your NEA FastAttach application or portal to complete the document attachment process.

When you generate claims that need an attachment, CareStack will identify those claims for you with the NEA designation. 

You'll add the attachments using the NEA application and its connection to CareStack. 

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  In the NEA Application

  1. Double-click the claim row in the NEA App. 
  2. Select the method you will use to add the attachments. The steps will be a bit different for different types of attachments. 
  3. Describe the attachment by answering the prompt questions. 
  4. When you've added all your attachments for the claim, click Save. 

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Once you are finished adding attachments to all your claims, click Send to send the finished claims back to CareStack for transmission to the clearinghouse. 

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The claims and their attachments will be transmitted from CareStack in the next claims sweep at 8 PM EST.



Claim Flags


Each tab on the Claim Slider features the Claim History -a timeline of the claim's story. In the timeline, you can track the claim's path through typical milestones:

CareStack has provided a set of the most common milestones as claim flags. Your practice can customize or add to them. To add the claim flag: 

  1. Select the flag you want from the drop-down list. You can even add free-form text to add more details to the claim flags. 
  2. Click Save

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Claims Gone Bad


Your claims won't always go according to plan. Despite your careful work, sometimes you need to crumple a claim and just start over. In CareStack you can do just that, literally or figuratively. 

You might have to give up on a claim you created when: 


No matter what happened to get you to this place, there are three options for abandoning or updating the claim (Which of those you get to do depends on whether or not the claim has been transmitted (submitted) and what went wrong ):

If the claim was NOT printed or Transmitted, 

Else if the claim was printed or transmitted, and the error was unrelated to the ADA codes within the claim or the patient,

Else if the claim was printed or transmitted, and the error relates to the codes - incorrect code, too many codes, not enough codes, or to the patient. 


Delete a Claim


If you've made a mistake on a claim that hasn't been submitted, it is easy to delete the claim draft and update the details for a fresh new claim. 

You can only delete a claim that has NOT yet been printed or submitted.

To delete a claim, you'll work in the Claims module. Claims that can be deleted will be found on the Claims: Pending Submission tab. To delete a claim:

  1. Select the claim to delete.
  2. Click the orange Actions button. 
  3. Select Delete from the drop-down menu.
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  4. Click Ok on the confirmation window.    

If you try to delete a claim that has been submitted, CareStack will warn you. 

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Whether you click Cancel or click Ok, your claim will not be deleted, and you'll be returned to the tab. Instead of deleting the claim, you'll have to void it. 

Once you delete the claim, you'll need to return to the chart and make the needed corrections. 

Once you've corrected the issue, the new and improved claim will be created when you or your team generates a batch job with that date of service or you can create the claim from the patient's original appointment. 


Edit and Resubmit a Claim


If you've made a mistake on a claim that you submitted, but the error doesn't affect the patient or code details, you can correct your mistake and resubmit it.

To edit and resubmit a claim, you'll work in the Claims module. Claims that can be edited will be found on the Claims: Pending Payment tab. To Edit and Resubmit a claim:

  1. Select the claim and open the Claim Form tab.
  2. Click the Edit & Resubmit button.
  3. Update the details directly on the claim. Only the fields you can update are unlocked. You will not be able to update patient fields.
  4. Click Submit.
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  5. Add the reason for your change and click Ok. This reason will be included in the claim history. 

CareStack DOES NOT synchronize the changes between the claim and the clinical record.

You must make any corresponding change in the patient's chart!  

Once you delete the claim, you'll need to return to the chart and make the needed corrections. 

Once you've corrected the issue, the new and improved claim will be created when you or your team generates a batch job with that date of service, or you can create the claim from the patient's original appointment.


Void a Claim


If you've made a mistake with the treatments, provider, or codes, on a claim you've submitted, you'll need to void it. When you delete a claim, it is as if it never existed. When you void a claim, there is still a record of the claim. It will still be listed in your All Claims tab and in the patient's ledger for your reference. 

To void a claim, you'll work in the Claims module. You can work from the Pending Payments tab or the All Claims tab. To void a claim: 

  1. For the claim, you wish to void, click the Status drop-down.
  2. Select Void from the status list.
  3. Complete the details in the Reason window and click Ok.
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    Once the claim has been voided, CareStack will prompt you to regenerate the claim. If you've corrected the issue, click Yes. CareStack will create the claim right away. If you still have corrections to make, click No.     


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You must make any corresponding change in the patient's chart before recreating the claim.


The Aftermath


Whether you have voided the claim or edited the claim and resubmitted it, chances are you need to make corrections to the code. 

Your best tool for that is the Code Snapshot. Access it from the chart, ledger, or appointment by clicking the code's link

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If you were able to edit a code and resubmit a claim, you'll still need to make the corresponding edit in the Code Snapshot:

  1. Change the surfaces if needed.
  2. Add a note to help communicate and document what happened.
  3. Click Save.    


Column Headers

For a voided claim, you'll need to remove the incorrect treatment code. However, a code cannot be simply deleted since it was once part of an active claim. Instead, you must cancel the code out:

In the Code Snapshot:

  1. Add the date in the Not applicable as of field.
  2. Change the total fee to $0.
  3. Click Save.
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Written by Athul V Suresh | Last published at: August 08, 2021


Electronic Data Interchange (EDI) is the computer-to-computer exchange of business documents in a standard electronic format between business partners.


ASC X12 Claim Transaction Life Cycle


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In healthcare EDI, there are several transaction types. The following transactions, included in the 5010 version of HIPAA-mandated healthcare ASC X12 transactions, are used most frequently in the dental industry. Through the collaboration of our members, NDEDIC (National Dental EDI Council ) works to standardize data sets and implementation guidelines that will maximize the value of the transactions for dental.


Written by Roshni R | Last published at: August 08, 2021


Imagine as the day winds up after reviewing all the appointments, charges, and insurance information and you just want to create every claim all at once, just like that. Yes!! That is possible within CareStack !!

You can just decide when to kick off the process and what Date of Service to use and these are in just a few clicks away. CareStack can do all the work to create every claim all at once


To kick off the batch, start at the System Menu > Claims module > Batch Jobs tab. Then,



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When we say complete the details for the batch, we are saying to describe the claims you want CareStack to create for you:


                                  Related image: ./carestack-questions-2023-03-02_files/1628004945004-1628004945004.png


In the example above, 



Once you click on Generate, you will receive a green confirmation message at the top-right of the screen: “Claim Generating Process Started Successfully”


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After this message, you will be able to see an icon stating “Generating Claims


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When the Claims have been successfully generated, a green toaster will appear at the top-right of the screen : “Batch paper/electronic claim(s) have been successfully generated


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After the Claim creation is completed , you would be able to see the status of the Batch Details in the Batch Jobs as Completed instead of pending. You can click on Apply Filter and View Claims to view the claims that have been created with details we used to create this batch.


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The claims will soon appear in the Claims: Pending Submission tab.


NOTE: You will still need to transmit or print the claims. Click View Claims to go directly to the Claims module.

Written by Rahul Krishnan | Last published at: August 08, 2021


Claim Flags


Each tab on the Claim Slider features the Claim History -a timeline of the claim's story. In the timeline, you can track the claim's path through typical milestones:


Many practices use flags to track communications with the carrier about the claim:


Adding Claim Flags


CareStack has provided a set of the most common milestones as claim flags. Your practice can customize or add to them.

To add the claim flag:

1. Select the flag you want from the drop-down list. The drop down list will display all the claim flags that are active. You can even add free-form text to add more details to the claim flags.

2. Click Save



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The claim flag will be added to the claim history and CareStack will automatically imprint the date and time as well as the name of the user who added that flag.


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Creating and Viewing Claim Flags


To view the current claim flags in your system:

1. From your system menu, navigate to Practice Settings > Payments > Claim flag  option.

2.You can view all the claim flags that have been set for your practice along with the description and color. You can also see if they are active or inactive.

3.To create a new claim flag, click  Add  at the top-right corner.

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 4.     A new line will appear on the grid:

                    a. Enter the desired Flag Name.

                    b. Add a description that will fully identify the purpose and use of the flag.

                    c. Select the desired color to be associated with this flag.

 5.Hit  Save  in the last column once you are finished.

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Claim History Timeline


The claim history would be shown as a different section in the Claim Details modal. The last entry would be shown at first with the rest of the status shown above by scrolling up

The Claim Statuses would be shown in blue color with each entry displaying the name of the user who changed the status, the timestamp of when it was changed and also if remarks or reference ids(NEA id) if available any.

Users would also be able to add custom claim flags to each status which would link that flag to the history timeline at the point of addition.

All active Claim Flags must be listed in a drop down from where user can choose a flag and add a comment to it and then post it to the history timeline which can be used to track the claim activity.

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The below screenshot shows the claim status flow for a primary claim which has a secondary claim associated with it.

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Written by Geo Thomas | Last published at: August 19, 2021


A claim can either be created manually for each patient, or it can be executed as a batch job. Whatever be the mode of claim creation, it passes through different stages. These stages are different for paper-based claims and electronic claims. In CareStack, each of these stages is known  as a claim status.


Paper-based claims


The paper based claims are those which are sent to the carriers either as a hardcopy via post or as an attachment via email.


Saved

When a claim is created, it will be in this status when all the required information are available

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Saved with Errors 

If there are any errors or missing information, then the claim would be in this status upon creation. The user could click on the claim, correct the errors and then click Save which would change the claim status to Saved.


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Submitted(Payor)


When the user clicks Print and Submit, the claim status will be changed to Submitted(Payor).


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For a claim in this status, any of the following actions can be done :


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If there is any error in the claim, it can be corrected and resubmitted to the carrier and claim status becomes Resubmitted(Payor). When changing to this status, a mandatory remark has to be captured after which the claim form should be opened in edit mode with the current data pre-populated. There should be Print & Resubmit as well as Cancel buttons.


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If the carrier requests to Enter Remarks for the claim, the required data can be entered and the claim is submitted again to the carrier. The previous status of the claim will be retained. A mandatory remark is to be captured on marking it so.



The user has the option to change the status of a claim to On Hold before submission once all mandatory fields are filled. This status is generally used for claims that shouldn't get transmitted alongside with other claims


Closed

When the claim raised is covered by the carrier, the claim status should be changed to Closed. A claim can be closed after posting payments or from the Claims grid. When a claim is closed, depending on the Billing order and insurance hierarchy of the patient higher order claims will be raised.

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When a claim is to be closed, a warning, "Any remaining insurance balances will be pushed to the patient if there are no higher order claims to be raised. Are you sure you want to continue?", should appear with Yes and No buttons. Clicking on Yes and proceeding further, modal should appear to capture Carrier Claim Control No. It can be a max of 18 characters long and can hold any character. There would also be a provision to capture a remark. Both these fields are non-mandatory.


For a closed claim, the following options will be available

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Rejected

When a claim is rejected by the carrier, the claim status will be changed to Rejected. When a claim is marked as rejected, modal should appear to capture Carrier Claim Control No. This is non-mandatory. It can be a max of 18 characters long and can hold any character. There should also be a provision to capture a mandatory remark.

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For a rejected claim, the following options are available



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Reopened

A claim is reopened to revise or change the applied payments. For a reopened claim, it can be brought back to its previous statuses


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Partially Paid

A claim becomes partially paid when any of the charge lines in the claim is marked for appeal during payments. 

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For a claim in partially paid status, any of the following actions can be done :


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Resubmitted

A claim can be resubmitted when the claim sent was either rejected by the carrier, partially paid or carrier reports Error in Claim. The further actions for a resubmitted claim will be the same as that of a claim in Submitted(Payor) status.


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Void

This is the final stage a claim can ever be in. Once a claim has been voided, no further actions can be taken over this claim. When a claim is voided, the charge lines associated with the claim will become unbilled. A claim can be voided after entering the Carrier Claim Control Number(CCN) and the remarks associated. Both CCN and Remarks are mandatory fields.



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All the details should be taken from the corresponding treatment plan of the patient


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As mentioned before, the status of a voided claim cannot be changed further. The only option available would be to print the claim. 


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This option would be seen when the claim is opened.


Electronic claims


When a claim is created it will be saved in any of the following statuses


The user will have the option to change the status of a claim to On Hold after checking all validations.


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For an electronic claim, electronic attachments can be added if the payor is supported by NEA fast attach. Electronic attachments may be required for some or all the procedures in a claim as mandated by the payor. Claims which have electronic attachment are being sent to NEA Fast attach.


Claims which are in Saved or On Hold status, and Saved with Errors statues can be transmitted(sent to the carrier) by following any of these 3 methods: 

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On transmitting an electronic claim from the system, the claim status will become Ready To Send

If the claim requires an electronic attachment then the claim status will become Documents Pending.

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During the transmission process, NEA recommended codes which have set electronic attachment as No, being handled throws a warning toaster where the user can either send them to NEA Fast attach or can skip. Transmit job process always sends the NEA recommended codes to NEA Fast attach.

Stage 1: E-Claim Electronic Attachment Submission, Electronic Claim Submission/Resubmission


NEA Status check job will check the status of Document Pending claims and changes claim status to Ready To Send or Ready To Send(R) once electronic attachment process completed in NEA Fast attach.

Related image: ./carestack-questions-2023-03-02_files/1629230139004-1629230139004.png

 A claim in Document Pending status can be force submitted and the claim status will be changed to Ready to Send or Ready To Send(R).


The Electronic Claim submission job which is being configured will pick up the claims which are in the above statuses and submits/resubmits those claims.

The claim is submitted/resubmitted to the clearinghouse which would change the claim status to Submitted(CH) or Resubmitted(CH).

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Stage 2: Submission/Resubmission to Clearing House, Clearing House Response


The claim statuses Submitted(CH) or Resubmitted(CH) will be updated after receiving the response from the clearinghouse. 

The claim status may become

If a claim is rejected from the Clearing House, the necessary changes are made and the claim needs to be submitted/Resubmitted again to the clearinghouse.

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When resubmitting a claim from Rejected(CH) status and that claim had previous NEA attachment, then before submitting/resubmitting the claim, a validation would be asked: 

When submitting/resubmitting a claim from Rejected(CH), and if the claim had no previous attachments, and if the treatment code is not being recommended by the carrier for NEA Attachment; then the claim will be moved to Ready to Send or Ready to Send(R) status. 

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And if it is recommended by NEA, a warning toaster will be shown where the user can decide whether to send that claim to NEA. ie, Document Pending or not sent to NEA so claim changes status to Ready to Send or Ready to Send(R) status.

For a claim in Rejected (CH) status, it can be submitted [not resubmit] again to the clearinghouse, then the previous claim status will be retained.

The claims accepted by the clearinghouse will be sent to the payor. Once the claim reaches the payor, their response will be received. Based on the response the claim status will be updated to any of the following based on the claim status category codes.


For an electronic claim in any of the above status, the following actions can be done.


Stage 3: Applying Insurance Payments to claims, Resubmitting Claims, Changing Claim status with respect to response


Electronic claims status can be manually changed or will be changed on applying insurance payments to the following statuses:


Closed

Claim status can be changed to Closed from the following claim statuses:

Claim status can be changed to Closed either manually or after posting the insurance payment against the claim by selecting close claim checkbox.

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When manually closing claims, a warning message will be shown "Any remaining insurance balances will be pushed to the patient if there is no higher order claim to be raised. Are you sure you want to continue?" 

On proceeding further modal shown with fields, 

Claim Control Number is a non-mandatory field and being auto-populated if the value being previously available and Remark is a non-mandatory text field.

If the code has billing order M or then no higher order claim will be raised, else corresponding higher order claim will be raised when moving a claim to Closed status.

Claims which are in Closed status will have following options in claim status drop-down:

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Above option will be visible only if possible to raise higher order claims and auto-generated higher order claims are deleted for some reason.

While opening a Closed claim, both the Details tab and the Claim form tab will be non-editable and only have a Print button in both tabs.

Rejected

Claim status can be changed to Rejected from the following claim statuses:

While changing claim status to Rejected, a modal would be shown with fields 

where Claim Control Number is a non-mandatory field and being auto-populated if the value being previously available and Remark is a mandatory text field.

Related image: ./carestack-questions-2023-03-02_files/1629230926611-1629230926611.pngClaims which are in Rejected status will have following options in claim status drop-down:

While opening a Rejected claim, both Details tab and Claim form tab will be non-editable and only have a Print button in both tabs.

Reopened

Claim status can be changed to Reopened from the following claim statuses:

While reopening claims, if they already have higher order claims raised, then a warning would be shown "You cannot reopen this claim since higher order claim(s) exist for it" and would not allow to change the claim status. 

If no higher order claim is present a modal with mandatory Remark text field will be shown where the user can enter remarks and reopen the claim.

Claims which are in Reopened status will have following options in claim status drop-down:

While opening a Reopened claim both Details tab and Claim form tab will be non-editable and only have a Print button in both tabs.

If the payor makes partial payments or rejects some or at least one of the procedure codes raised in the claim, the claim status will be changed to Partially Paid.

Void

Claim status can be changed to Void status from the following claim statuses:

While changing the claim status to Void, a modal would be shown with fields 

where Claim Control Number is a mandatory field and will be auto-populated if the value is previously available and the Remark field is also a mandatory text field.

After that, a modal popup showing the message "Do you want to generate a new claim from the void claim?" 


Claims which are in Void status won't have any option in claim status section. While opening such a claim, both the Details tab and Claim form tab will be non-editable and will only have a Print button.


Claim Rejection statuses


There are a few claim rejection statuses that the carriers use when they reject a claim. These can be seen in case of electronic claims.  The details regarding these are available in the attached link.


https://x12.org/codes/claim-status-category-codes 



Written by Renganathan K | Last published at: August 15, 2021



Many insurance companies need you to submit attachments with your claims, but no one wants paperwork flying about on the internet. When you submit claims and authorizations using CareStack, you may use NEA Fast-Attach to include the attachments that the carriers require.

You will need to log in to your NEA FastAttach application or portal to attach the required documents.

When a generated claim is required to have documents attached to it CareStack will identify them and tag them as NEA next to the claim id as shown in the image below.


Related image: ./carestack-questions-2023-03-02_files/1628007732232-1628007732232.png


Once you are on the NEA application


Related image: ./carestack-questions-2023-03-02_files/1628007771103-1628007771103.png


Once you are finished adding attachments to all your claims, click Send to send the finished claims  back to CareStack for transmission to the clearinghouse.


Related image: ./carestack-questions-2023-03-02_files/1628007796611-1628007796611.png 


The claims and their attachments will be transmitted from CareStack in the next claims sweep. 


You may also refer to this webpage for more information : https://vynedental.com/ 


NEA Recommendation 

Practices can set their NEA recommendation codes under 

System Menu > Practice settings > Payments > NEA Recommendation

Here we can add the required codes and their corresponding Document type to be attached and their corresponding Carrier details. 

 Once this is done whenever these codes get completed and a claim is raised  they will be having NEA tag . These claims will be searched in 

Related image: ./carestack-questions-2023-03-02_files/1628007825228-1628007825228.png

NEA applications and required documents can be attached and sent.


Written by Aswathy B Nair | Last published at: August 08, 2021


1. ADA 2002 form have dual usage in our system

2. Below are the fields which are mentioned as boxes in an ADA 2002 form


HEADER INFORMATION

(The ‘header’ provides information about the type of submission being made.)

Box 1

Box 2


PRIMARY PAYER INFORMATION

Box 3

i. Insurance Company Name: This should be populated with the name of the insurance company to whom the form is to be sent and should be disabled.

ii. Address Line 1: This should be a text field populated with the first line of address as saved in the field 'Address Line 1' under Practice Settings > Plan screen of the respective plan and is editable.

iii. Address Line 2: This should be a text field populated with the second line of address as saved in the field 'Address Line 2' under Practice Settings > Plan screen of the respective plan and is editable. If the address of the insurance company does not have address line 2, then the area for 'Address Line 2' should be left blank.

iv. City: This should be a text field populated with the city as saved in the field 'City' under Practice Settings > Plan screen of the respective plan and is editable.

v. State: This should be a chosen box that lists all states in the US and pre-populated with the state as saved in the field 'State' under Practice Settings > Plan screen of the respective plan and is editable. The full name of the states should be shown in the list for eg: Florida, Alabama etc, but only the code of the selected state should be displayed in the collapsed view of the chosen box. for eg: FL, AL etc

vi. Zip Code: This should be populated with the zip code as saved under the field 'Zip Code' under Practice Settings > Plan screen of the respective plan and is editable.


OTHER COVERAGE

(This area of the claim form provides information on the existence of additional dental or medical insurance policies.)

Box 4

i. If the coverage is 'Dental', then boxes 5 through 11 will get populated with the details of the applicable dental plan.

ii. If the coverage is 'Medical', then boxes 5 through 11 will get populated with the details of the applicable medical plan.

iii. If the patient has both medical and dental coverage, boxes 5 through 11 will get populated with the details of the dental plan.

Box 5

Box 6

Box 7

Box 8

Box 9

Box 10

Box 11

i. Insurance Company Name: This should be populated with the name of the insurance company and should be disabled.

ii. Address Line 1: This should be a text field populated with the first line of the address of the carrier as saved under the insurance plan (Practice Settings > Plan) and is editable.

iii. Address Line 2: This should be a text field populated with the second line of the address of the carrier as saved under the insurance plan(Practice Settings > Plan) and is editable. If the address of the policyholder does not have address line 2, then the area for 'Address Line 2' should be left blank.

iv. City: This should be a text field populated with the city of the carrier as saved under the plan (Practice Settings > Plan) and is editable.

v. State: This should be a chosen box that lists all states in the US and prepopulated with the state as saved under the insurance plan and is editable. The full name of the states should be shown in the list for eg: Florida, Alabama etc, but only the code of the selected state should be displayed in the collapsed view of the chosen box. for eg: FL, AL etc

vi. Zip Code: This should be a text field populated with the zip code as saved under the insurance plan and is editable.


POLICYHOLDER/SUBSCRIBER INFORMATION

(This section (Box 12-Box 17) documents the information of the person(policyholder) who holds the insurance(indicated in box 3) to which the form is going to be submitted)

Box 12

i. Policyholder Name: This value should be in the format 'Last Name, First Name, Middle Initial, Suffix'. This value is populated from the field 'Policy Holder Name' under Patients > Insurances. This value will be pre-populated and in disabled format.

ii. Address Line 1: This value will be populated from the field 'Address Line 1' under Patient > General > Basic Information of the policyholder(a policyholder is also identified as a patient in our system.). This will be a text box and will be editable.

iii. Address Line 2: This value will be populated from the field 'Address Line 2' under Patient>General>Basic Information of the policyholder(a policyholder is identified as a patient in our system.). This will be a text box and will be editable. If the address of the policyholder does not have address line 2, then the area for 'Address Line 2' should be left blank.

iv. City: This value will be populated from the field 'City' under Patient>General>Basic Information of the policyholder(a policyholder is identified as a patient in our system.). This will be a text box and will be editable.

v. State: This value will be populated from the field 'State' under Patient>General>Basic Information of the policyholder(a policyholder is identified as a patient in our system.). This will be a chosen box with the lists of all states in the US. The full name of the states should be shown in the list for eg: Florida, Alabama etc, but only the code of the selected state should be displayed in the collapsed view of the chosen box. for eg: FL, AL etc

vi. Zip Code: This value will be populated from the field 'Zip Code' under Patient > General > Basic Information of the policyholder(a policyholder is identified as a patient in our system.). This will be a text box and will be editable.

The values Policy Holder Name, Address Line 1, City, State, and Zip Code are mandatory fields.

Box 13


Box 15

Box 16

Box 17


PATIENT INFORMATION

(This section (Box 18-Box 23) documents the information of the patient on behalf of which the form is to be submitted.)

Box 18

Box 19

Box 20

i. Patient Name: This value should be in the format 'Last Name, First Name, Middle Initial, Suffix'. This value is populated from the respective fields under Patients > Insurances. This value will be pre populated and in disabled format.

ii. Address Line 1: This value will be populated from the field 'Address Line 1' under Patient > General > Basic Information of the patient(on behalf of which the form is to be submitted). This will be a text box and will be editable.

iii. Address Line 2: This value will be populated from the field 'Address Line 2' under Patient > General > Basic Information of the patient(on behalf of which the form is to be submitted). This will be a text box and will be editable. If the address of the patient does not have address line 2, then the area for 'Address Line 2' should be left blank.

iv. City: This value will be populated from the field 'City' under Patient > General > Basic Information of the patient(on behalf of which the form is to be submitted). This will be a text box and will be editable.

v. State: This value will be populated from the field 'State' under Patient > General > Basic Information of the patient(on behalf of which the form is to be submitted). This will be a chosen box with the lists of all states in the US. The full name of the states should be shown in the list for eg: Florida, Alabama etc, but only the code of the selected state should be displayed in the collapsed view of the chosen box. for eg: FL, AL etc

vi. Zip Code: This value will be populated from the field 'Zip Code' under Patient > General > Basic Information of the patient(on behalf of which the form is to be submitted). This will be a text box and will be editable.


Box 21

Box 22

Box 23


RECORD OF SERVICES PROVIDED

(The ‘Record Of Services Provided' section (Box 24 - Box 35) contains a grid that contains information regarding the proposed treatment (predetermination/preauthorization), or treatment performed (actual services)).

Box 24

Box 25

Box 26

Box 27

Box 28

Box 29

Box 30

Box 31

Box 32

Box 33

Box 34

Box 35


AUTHORIZATIONS

(This section(Box 36 - Box 37) provides consent for treatment as well as permission for the carrier to send any patient benefit available for procedures performed directly to the dentist or the dental business entity.)

Box 36

Box 37


ANCILLARY CLAIM/TREATMENT INFORMATION

(This section(Box 38 - Box 47) of the claim form provides additional information to the third party payer regarding the claim.)

Box 38

Box 39

Box 40

Box 41

Box 42

Box 43

Box 44

Box 45

Box 46

Box 47


BILLING DENTIST OR DENTAL ENTITY

(The ‘Billing Dentist’ or ‘Dental Entity’ section(Box 48 - Box 52) provides information on the individual dentist’s name, the name of the practitioner providing care within the scope of their state license, or the name of the group practice/corporation that is responsible for billing and other pertinent information.)

Box 48

Box 49

Box 50

Box 51

Box 52


TREATING DENTIST AND TREATMENT LOCATION INFORMATION

(Information that is specific to the dentist or practitioner acting within the scope of their state licensure who has provided treatment is entered in this section (Box 53 - Box 58))

Box 53

Box 54

Box 55

Box 56

i. Address Line 1: This should be an editable text field populated with the first line of the address of the provider from the field 'Address Line 1' in the screen Practice Settings > Administration > Users of the respective treating provider.

i. Address Line 2: This should be an editable text field populated with the second line of the address of the provider from the field 'Address Line 2' in the screen Practice Settings > Administration > Users of the respective treating provider. If the address of the provider does not have address line 2, then the area for 'Address Line 2' should be left blank.

iii. City: This should be an editable text field populated with the city of the provider from the field 'City' in the screen Practice Settings > Administration > Users of the respective treating provider.

iv. State: This should be an editable chosen box that lists all states in the US and prepopulated with the state of the provider from the field 'State' in the screen Practice Settings > Administration > Users of the respective treating provider. The full name of the states should be shown in the list for eg: Florida, Alabama etc, but only the code of the selected state should be displayed in the collapsed view of the chosen box. for eg: FL, AL etc

v. Zip Code: This should be an editable text field populated with the zip code of the provider from the field 'Zip Code' in the screen Practice Settings > Administration > Users of the respective treating provider.

Box 57

Box 58


ASSIGN BENEFITS TO PATIENT

Case 1: An ABP label is added to the patient and the claims are not submitted:



Case 2: A claim has been submitted and the ABP flag is added after submission




Note:

ABP flag

CLM08

ON

N

OFF

Y


ADA 2002 Claim Form

Related image: ./carestack-questions-2023-03-02_files/1628019965047-1628019965046.png


Written by Aswathy B Nair | Last published at: August 22, 2021


1. ADA 2012 form have dual usage in our system

2. Below are the fields which are mentioned as boxes in an ADA 2012 form

HEADER INFORMATION


(The ‘header’ provides information about the type of submission being made.)


INSURANCE COMPANY/DENTAL BENEFIT PLAN INFORMATION


OTHER COVERAGE

(This area of the claim form provides information on the existence of additional dental or medical insurance policies.)


POLICYHOLDER/SUBSCRIBER INFORMATION

(This section (Box 12-Box 17) documents the information of the person(policyholder) who holds the insurance(indicated in box 3) to which the form is going to be submitted)


PATIENT INFORMATION

(This section (Box 18-Box 23) documents the information of the patient on behalf of which the form is to be submitted.


RECORD OF SERVICES PROVIDED

(The ‘Record Of Services Provided' section (Box 24 - Box 35) contains a grid that contains information regarding the proposed treatment (predetermination/preauthorization), or treatment performed (actual services)).


AUTHORIZATIONS

(This section(Box 36 - Box 37) provides consent for treatment as well as permission for the payer to send any patient benefit available for procedures performed directly to the dentist or the dental business entity.)


ANCILLARY CLAIM/TREATMENT INFORMATION

(This section(Box 38 - Box 47) of the claim form provides additional information to the third party payer regarding the claim.)


BILLING DENTIST OR DENTAL ENTITY

(The ‘Billing Dentist’ or ‘Dental Entity’ section(Box 48 - Box 52a) provides information on the individual dentist’s name, the name of the practitioner providing care within the scope of their state licensure, or the name of the group practice/corporation that is responsible for billing and other pertinent information.)

c. This is not a mandatory field and will be an editable text field.



TREATING DENTIST AND TREATMENT LOCATION INFORMATION

(Information that is specific to the dentist or practitioner acting within the scope of their state licensure who has provided treatment is entered in this section (Box 53 - Box 58))


ASSIGN BENEFITS TO PATIENT

Case 1: An ABP label is added to the patient and the claims are not submitted:



Case 2: A claim has been submitted and the ABP flag is added after submission


Note:



ABP flag

CLM08

ON

N

OFF

Y


ADA 2012 Claim Form



Related image: ./carestack-questions-2023-03-02_files/1628061374507-1628061374507.png


Written by Aswathy B Nair | Last published at: August 22, 2021


1. CMS 1500 form is used as a claim form for sending claims to the insurance companies on behalf of the patient.

2. Below are the fields which is mentioned as items in CMS 1500 form


Payer Block

(The ‘Carrier Block’ located in the upper center and right margin of the form)


Patient And Insured Information (ITEMS 1–13)























Physician Or Supplier Information(ITEMS 14–33)






































Assign Benefits To Patient

The Assign Benefits to Patient (ABP) flag can be added to the patient to ensure that the claims/pre-auths are billed against the patient and not the Billing Dentist/Dental Entity on behalf of the patient. 

Once the label is added this would have impacts on the fields 13 & 33 of Medical Claim form

Case 1An ABP label is added to the patient and the claims are not yet submitted:

Case 2: A claim has been submitted and the ABP flag is added after submission


CMS 1500 Claim Form

Related image: ./carestack-questions-2023-03-02_files/1628159684322-1628159684322.png

Written by Rinu Seba Joemon | Last published at: August 08, 2021


Claim Connect


Overview

CareStack integrates with DentalXChange as a partner organization to facilitate the transmission and processing of electronic dental and medical claims from dental organizations. These organizations must enroll with DentalXChange and request the linkage for CareStack from the support team. 


This document contains the integration status, scope, steps to configure, existing clients using ClaimConnect, clients requesting claim connect, and limitations & restrictions on using integration.


About DXC ClaimConnect

ClaimConnect is the premiere EDI solution for online dental claims delivery and real-time services. This platform processes dental insurance claims sends attachments and retrieves eligibility and benefits info. ClaimConnect also has superior customer service, offering you the perfect solution for all of your EDI dental claims needs.


Features available in ClaimConnect


Scope of Integration 

Practices who have the clearinghouse ‘DentalXChange’ would have an option to enable the ClaimConnect (location level) by entering the username and password they received from DXC. Also when enabled the NEA configuration (if present) would be cleared. After enabling ClaimConnect, all electronic claims and preauthorizations in the ‘Ready to Send’ or ‘Ready to Send(R)’ status would be uploaded to the ClaimConnect portal at the end of every day.


Status of Integration

Status: Completed the Current Scope

CareStack provides the option to configure ClaimConnect credentials and thus enables users to submit electronic claims and preauthorizations to the ClaimConnect portal. Once the claims and preauthorizations are uploaded to the portal, the users can see the entire claim and preauthorization information.


Steps to Enable & User ClaimConnect Portal

When DXC ClaimConnect is enabled for a location, all electronic claims and preauthorizations created for that location will be uploaded to the ClaimConnect portal (claims are automatically uploaded to the portal every day at 08:30 PM EST).


CareStack provides DXC ClaimConnect configuration where users can enter username and password and thus enable ClaimConnect for that specific location. When ClaimConnect is enabled for a location the NEA configuration set for that location will get automatically removed.


Users can change the electronic claims and preauthorizations status to Ready To Send or Ready to Send(R) status and these claims will be uploaded to the ClaimConnect portal every day at 08:30 PM EST. Once uploaded the claim and preauthorization status will be changed to Submitted(CH) and Pending respectively.


CareStack Integration Additional Details

Add DentalXChange Credentials

Once the DentalXChange option for ClaimConnect is enabled by the CareStack support team, you will be ready to enter your credentials and set up your locations.

You may navigate to the System menu > Practice Settings > Payments >Billing Services.


Related image: ./carestack-questions-2023-03-02_files/1628250722979-1628250722979.png


Click the desired location’s row to open the individual details > Select the Claim Connect tab > Click Edit to enable the fields > Enter the DentalXChange Claim Connect credentials provided by DentalXChange > Click Save. 


Related image: ./carestack-questions-2023-03-02_files/1628250823512-1628250823512.png


NOTE: Claim Connect does not integrate with NEA so enabling Claim Connect will disconnect NEA from this location. You will need to send attachments another way.



Denti-Cal


EDI enrolled providers will be ready to start submitting electronic Claims and Treatment Authorization Requests (TARs) once the practice management system vendor has verified that their system is able to connect to the DentiCal EDI system either directly or through a clearinghouse, data format testing has been successfully completed, and Denti-Cal's EDI Support Department has confirmed enrollment in the Electronic Data Interchange (EDI)Program.


Four Basic Steps

There are four basic steps to follow to submit claims electronically

1. Enter claim information

2. Transmit data

3. Retrieve and review reports and files returned from Denti-Cal

4.Prepare and mail EDI labels - only for claims and TARs that require radiographs or attachments.


1.Enter Claim Information


Note: The registration number must be included.


2.Transmit Data


3.Retrieve and Review Reports and Files


4.Prepare and Mail Radiographs/Attachments with EDI Labels


Note: This step is not needed if submitting radiographs and images digitally and the digitized image reference numbers are received by Denti-Cal with EDI claim data.


EDI Labels

If procedures submitted electronically require radiographs and/or attachments or if a provider indicates they wish to submit documentation, the claim/TAR will be "suspended" until the documentation is received. Special self-adhesive EDI labels and EDI envelopes printed in red ink are available to facilitate mailing Xrays/attachments to process “suspended” EDI claims and TARs.


Preparing EDI Labels

EDI labels may be ordered in one of three styles to accommodate different types of printers; laser labels, 1-up (across), or 3-up continuous labels. Most providers use partially preprinted labels, however, providers may wish to check with their vendor to determine which type of labels will work best for their system.


Note: EDI labels are only required to submit radiographs and/or attachments when a claim is initially sent electronically. EDI labels are not requested if digitized images are received. 


Labels must have the following

1.Billing NPI next to “Denti-Cal Provider ID”  

2.Beneficiary first and last name below “Patient MEDS ID” 

3.Denti-Cal DCN also referred to as the Base DCN 

4.Provider's name and return address 


Related image: ./carestack-questions-2023-03-02_files/1628249867515-1628249867515.png

EDI labels without these items cannot be processed and must be returned for completion. Other information may be included but is not mandatory. The pink area is only used by Denti-Cal during processing. 


Sending Digitized Images of Radiographs & Attachments

In conjunction with electronically submitted documents, Denti-Cal accepts digitized images submitted through electronic attachment vendors: DentalXChange, National Electronic Attachment, Inc. (NEA), National Information Services (NIS), and Tesia Clearinghouse, LLC.


Related image: ./carestack-questions-2023-03-02_files/1628257771347-1628257771347.png


Electronic Vendor and Document Specifications

DentalXChange Users: Create the claim or TAR. Before transmitting a document electronically, include the radiographs/photographs and attachments. Each attachment must include the date the images were created. For additional information, providers can call DentalXChange at (800) 576-6412 ext. 455 or visit.

http://www.DentalXChange.com/provider/claimconnect/AttachmentPage. 


NEA Users: Radiographs/photographs and attachments must be transmitted to NEA before submitting an EDI claim or TAR. NEA’s reference number must be entered on the EDI claim or TAR using the following format: “NEA#” followed by the reference number, with no spaces - Example: NEA#9999999. It is important to use this format and sequence. 


Some dental practice management and electronic claims clearinghouse software have an interface with NEA that automatically enters the reference number into the notes of the claim. For additional information, providers can visit www.nea-fast.com or call (800) 782-5150 option3. 


Resubmission Turnaround Documents (RTDs) & Notices of Authorization (NOAs)

Depending on how the provider’s software is set up, providers will receive RTDs and Notices of Authorization (NOAs) electronically or by mail from Denti-Cal along with other EDI reports. It is standard procedure to enroll providers to receive their EDI RTDs and NOAs electronically for documents submitted electronically. They are issued along with other EDI reports. However, providers may opt to receive RTDs and/or NOAs on paper through the mail. 


RTDs: RTDs (also referred to as Notices of Resubmission) will be issued by Denti-Cal if additional information is needed to process the EDI document. RTDs cannot be returned electronically. Providers should retrieve EDI RTDs, print them to paper, and mail them to Denti-Cal with any necessary documentation attached. RTDs should be returned promptly. Documents will be denied if no response to the RTD is received within 45 calendar days. EDI labels and envelopes should not be used for RTDs. 


NOAs: Providers should also retrieve EDI NOAs and either print them to paper for submission by mail or if the provider’s system or clearinghouse can accept them, transmit them electronically to Denti-Cal.


Note: Printed RTDs and NOAs should be completed and signed in blue ink and mailed to Denti-Cal in a white mailing envelope for processing.


Claim Inquiry Forms (CIFs): Claim Inquiry Forms cannot be submitted electronically. A CIF can be mailed only after a document is processed to request a change or reevaluation or to request the status of a claim or TAR.

Status of Integration


The grid in Menu > Claims > Denti-Cal would have the following columns:

The Report Type and Descriptions are as follows:

Related image: ./carestack-questions-2023-03-02_files/1628257875476-1628257875476.png


Written by Abhishek Vijay | Last published at: August 08, 2021


Added medical insurance to a patient: ✔

Made sure that the insurance is verified: ✔

Created a claim for the services rendered: ✔

But wait, why does the claim look all different than the usual ones?


A health insurance claim, also known as a medical insurance claim, is a request made by the policyholder for reimbursement of treatment costs incurred to a healthcare provider.

The sum allocated by the dental insurance will not be enough to cover the procedures needed in a given year for many patients, especially those with serious tooth concerns. If the circumstances of these patients' ailments fit under the medical billing codes for dental procedures, accepting medical insurance may make it possible for them to receive the dental treatments they require.

Medical billing is a payment method used in the United States healthcare system. To get paid for services given, including testing, treatments, and procedures, a healthcare professional must submit, follow up on, and appeal claims with health insurance companies. 


Many dentists are asked to submit dental procedures to a patient's medical plan, either at the request of the patient's dental plan or at the request of the patient. Submitting medical claims for dental treatments such as surgical extractions, trauma-related procedures, and biopsies can leave dental team members feeling overwhelmed and angry. However, filing a medical claim is not as difficult as it may appear, and it differs from filing a dental claim.


We can add Medical Insurance, raise a claim for services rendered, and bill for payments. The procedure is similar to that of Dental Insurance/claims, with slight variations.


So consider a situation where you have added and completed a Medical Code. Now, since the patient has a medical claim, we can bill the services rendered.


Related image: ./carestack-questions-2023-03-02_files/1627992588290-1627992588290.png


For a Medical Code, if the medical insurance is active, the Billing Order would reflect ‘M’, indicating medical. You can now right-click on the code and select create a claim.

Voila! Now you have created a medical claim. (if the claim isn't created and errors are present, whelp, it's troubleshooting time.) A Medical Claim would look a little something like this.

Related image: ./carestack-questions-2023-03-02_files/1627992696976-1627992696976.pngWhile creating a medical claim in CareStack, it would reflect in this manner.

Related image: ./carestack-questions-2023-03-02_files/1627992998436-1627992998436.png
You would have noticed terms like CDT, CPT, and CDT-CPT Crosswalk. What are those?


If there are no applicable medical cross codes or when the CDT is the most accurate code to reflect the dental procedure performed, many medical payers will accept the CDT code.

Locate your claim in the patient's profile or the Claims module (Menu > Claims), then click the row of the claim to open the claim details.

Click the  CH  hyperlink next to the dental procedure code needing cross-coding (Line #24). The standard CPT codes, if any, will appear for the selected dental code.

Related image: ./carestack-questions-2023-03-02_files/1627993045604-1627993045604.png


Hint:  Click Add on the top-right to search for and select your preferred CPT code if needed.


Related image: ./carestack-questions-2023-03-02_files/1627993157625-1627993157624.png


Checkmark the codes you want to include on the claim, then click Apply. Repeat until all of the necessary procedures have been cross-coded The selected CPT codes will replace the dental code on the claim. (Note that the original dental codes will remain in the patient's treatment plan, ledger. etc.)

Related image: ./carestack-questions-2023-03-02_files/1627993275526-1627993275526.png


Hint:  For a list of the standard codes for cross-coding, click the CDT - CPT Crosswalk tab at the top of the window.


Related image: ./carestack-questions-2023-03-02_files/1627993343761-1627993343761.png


Once all of the cross-coding is done, complete and submit your claim as usual!

Solely a few payers will only accept an electronic medical claim; the majority will still accept a paper form.

When making a medical claim, it is critical to follow the claim form instructions to the letter. The use of punctuation (i.e., a decimal point in the ICD code), the absence of a description when reporting an unlisted CPT code, and the inclusion of the appropriate modifier or qualifier, where required, are all examples of common claim form errors.

Written by Aravind M | Last published at: October 06, 2022


BluePay, a leading provider of technology-enabled payment processing for North American merchants, has been integrated into Clover as part of the First Data/Fiserv family. The company has consolidated its payment processing solutions and content under the Clover brand, which helps add additional features and functionality to Clover’s comprehensive offering of small business merchant services. 

https://www.clover.com/



Integration Support Contacts:

 bluepay-integration@fiserv.com, mel.sleight@fiserv.com, tommy.miller@fiserv.com



FAQs: 

  1. The timezone is used to show the transaction date in the Bluepay portal?

    All times reported by BluePay are Central Time with changes for daylight savings. Currently, times are Central Standard Time (CST)
    CST = UTC - 6 hours
    CDT = UTC - 5 hours

    As per the email sent on December 9th, 2021.

  2. "ERROR SELECTING PROCESSOR" when trying to make Bluepay payments
    This error happened because the Bluepay account isn’t configured to process ACH.

  3. How to review whether the BluePay payment was initiated from CareStack or not? 
    Bluepay payment can be done either from PMS (patient or insurance or collection payments) or from external portal (t2p portal or patient portal). The payment initiated information can be identified using the shpf-form-id value under the 'Merchant Data' section (Login to BluePay portal and go open the transaction). If the payment initiated is from :
    1. PMS then shpf-form-id value will be CarestackPMS01.
    2. T2P or Patient Portal or Statement Scan & Pay then shpf-form-id value will be CarestackPrtl01.

      Also the Custom ID 1 and Custom ID 2 feild will have value, where Custom ID 1 will have the value from billing.paymenttransaction table and Custom ID 2 will have the accountid value.
  4. How transactions can happend with a different shpf-form-id other than CarestackPrtl01 and CarestackPMS01?   
    1. If the value is VT then it is the Virtual Terminal. That means someone logged into the gateway account and ran the transaction manually.
    2. Origin = bp10emu form id = mobilecap01D means that a customer ran the transaction through the below payment form. 
      https://secure.bluepay.com/interfaces/shpf?SHPF_FORM_ID=mobilecap01D
      1. The payment form is something the practice generate using BluePay URL generator (https://secure.bluepay.com/interfaces/support/urlgeneratorform)

        Note: All the payments with these shpf-form-id will not create the invoice inside CareStack. User needs to manually create the receipt for the patient by selecting payment type and overriding the payment gateway workflow.  
         




Written by Aravind M | Last published at: December 17, 2021


National Electronic Attachments, Inc. (NEA) is a clearinghouse that uses its FastAttach service to transmit attachments, in support of electronic claims, to payors via the Internet.


Integration Support Contacts:

greg.samford@vynedental.com, nicole.smith@vynecorp.com, nicole.smith@vynecorp.com 


FAQs: 

  1. Showing error 'Invalid Login credentials' when trying to create/submit claims/preauthorizations
    • One reason can be user configured wrong (completely wrong facility ID, expired facility ID, facility ID with additional space or symbols) NEA facilityID.
    • Practice might have configured the master facility ID. Attached email thread with NEA regarding this. 

      That facility ID BJ124057 is for their master account, which cannot receive claim information. The claim information would need to be sent to either BJ124054 (Sun City West practice) or BJ124055 (Sun City practice). The purpose of the master account is to provide FastAttach users with a single login to manage and send attachments from all other accounts linked to the master account. The users can log into FastAttach using BJ124057. However, Carestack needs to be configured to send claim info to BJ124054 and/or BJ124055. For example, if they have two Carestack accounts (1 per location), each account can be configured to send claim info to their respective facility ID. When the user logs into BJ124057, they will see all of the attachment requests for both accounts and will be able to work the attachments from there. When they send the attachments, the NEA#s will route to the appropriate claims in Carestack. 

    • Letters in the facility ID need to be capitalized

Written by Aravind M | Last published at: February 16, 2022


DXC Payor List:

DXCPayerList

Claim: Live means they are supported either via print or electronically.

Eligibility:  This means the payer supports a basic eligibility check and returns “yes” or “no” responses.

Benefits: This means the payer offers more detailed benefit information.

ClaimStatus: This means the payer offers claims status updates.

ERA: It will be live if the payor sends ERA.

RT Claim: If “true” means the claim goes to the payer in real-time/instantly.

DXCAttachment: It will be live if the payor supports electronic attachments.

  

Written by Aravind M | Last published at: October 03, 2022


CareStack collaborates with CPS, a third-party print and mail processing business, to send (mail) to patients.


Integration Support Contacts:

Kyle Richmond - krichmond@cpsstatements.com

Kim - ktrenner@cpsstatements.com 


FAQ:

  1. Average Time to Receive Patient Statement.

    The USPS states 3-5 business days for delivery. We have the file for 1-2 days depending on the weekend or when the files come in before entering the USPS.


Written by Aswathy B Nair | Last published at: August 25, 2022


Medical History forms are records that keep track of the medical history of the patient like the allergies, conditions, and the other records as required by the practice. 

The medical History form has three parts: Medical Alerts, Dental Questionnaire, and Medical Questionnaire.

Before going into the details let's see the permissions required for the feature.

Permissions


Permissions for Medical Alerts and Medical History forms are set under System menu > Practice settings > Administration > Profiles > Manage Permissions > Patient > Medical Alerts and Medical History Form.

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Overview


Medical History form of a patient can be accessed under the patient profile. To access the same, you can go to the patient's profile and there on the left side, you can see a tab, Med. Hist.

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When you click that, you will be taken to the Medical History forms of the patient. 

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You will be able to see the red notification on the tab if the medical history form is patient/provider signature pending. A provider signature pending is highlighted in Yellow, while a patient signature pending is highlighted in Red. You would also be able to know that there is a pending medical history form by looking into the

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Medical History Form Settings


As discussed earlier, Medical History form has three parts. Medical Alerts, Dental Questionnaire and Medical Questionnaire. So let us first discuss where we set all these in order to get them reflected on the form.

Medical Alerts

Where do we set Medical alerts?

Lets see how we can create a Medical Alerts. Medical Alerts are set under System Menu > Practice Settings > Medical Alerts > Add. A pop up box appears where you can enter the details.

Click on Save and a green toaster will be seen on the top right showing that the Alert is created successfully.

*Note: The newly added Alerts would reflect only to the forms that are added after the alert was created.



To deactivate a Medical Alert, you can select the alert > Click on Actions > Deactivate.

Related image: ./carestack-questions-2023-03-02_files/helpjuice_production_uploads_upload_image_9675_direct_1629110013018-med3.gif


Under Practice Settings, we can set questions for Adults and Children separately. This helps us to set different questions for the patients depending on their age category.

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Dental Questionnaire

The Dental Questionnaire allows you to ask dental question to the patient through the medical history form. You will be able to add sections and questions from System menu > Practice settings > Medical History Forms > Adult(or child) > Dental Questionnaire.

Add Section: The Section component can be used to Add a new Section.

Related image: ./carestack-questions-2023-03-02_files/1654062205916-1654062205916.png

Add QuestionThis will help you add new questions.

When you add a new question, you will have to fill three fields

You want to change the position of question? You will be able to drag and bring questions under different sections. Just click and hold on the three lines to the left of each question and drag to where you want the question to be placed.

To delete a Section or Question, you can click the trash icon corresponding to each of them.


Medical Questionnaire

You will be able to ask other medical questions here. Here also you have the provision to add section and question just like we saw in Dental Questionnaire.

Add Section: The Section component can be used to Add a new Section 

Add QuestionThis will help you add new questions just like we did in the Dental Questionnaire.

When you add a new question, you will have to fill three fields

You want to change the position of question? You will be able to drag and bring questions under different sections. Just click and hold on the three lines to the left of each question and drag to where you want the question to be placed.

To delete a Section or Question, you can click the trash icon corresponding to each of them.

Settings

Settings has two sections: Signatures and Triggers

Signatures: By clicking the check mark you can include the provider sign in the Medical History form. 

Triggers: 



Related image: ./carestack-questions-2023-03-02_files/1629450020896-1629450020896.png


How to add a New Medical History Form for a Patient


To add a new Medical History Form, you can click on Add New Form on the Med. Hist page of a patient. This will create a new form which populates all the previously added answers(in case of existing patients). So here, you have three tabs: Medical Alerts, Dental Questionnaire and Medical Questionnaire.

Medical Alerts

Medical Alerts are the allergies and conditions the patient has. This gets automatically tagged to a patient stemming from the answers they provided on their Medical History Form. 

The very first tab in Medical History form is Medical Alerts. Here, all the active Medical Alerts will be listed. The patient will have to fill all of them. 

Only once you fill all the fields in this tab, you will be able to go to the next tab. Until then the 'Next' button on the bottom right will be greyed out. 

You have an option to Mark all as No. This is an easier way to fill the Medical Alerts. You can click on this button which marks all the fields in this tab as No and then you can mark the necessary ones to Yes as per the patient. This feature is very helpful as this will make sure that all the alerts are filled. 

Related image: ./carestack-questions-2023-03-02_files/1654062309896-1654062309896.png



Dental Questionnaire

Dental questionnaire has all the questions from the the one we have set under Practice settings. You have to fill all the mandatory questions under this tab and then only you would be able to move to the next tab. All the mandatory questions will have a red asterisk(*) on them. 

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Medical Questionnaire

Just like we saw for Dental Questionnaire, we have to fill the questions for Medical Questionnaire as well. And you have to fill in the mandatory questions, only then you will be able to print and sign the form. On this page, the patient and the provider can sign. 

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The form will be completed only when the provider signs it. Or if you hit 'Print and Sign', the form changes to completed and then the provider has to sign the form in the printed form.

Note:

The Medical History forms that are pending to be signed by the provider can be seen in the Huddle Dashboard under Pending Signature Med Hx

Related image: ./carestack-questions-2023-03-02_files/1629453797904-1629453797904.png


Where can a patient fill the Med Hx form


A patient can fill his medical history forms from three different places.

1. Patient's profile > Med Hx tab on the left

As we have seen earlier, a patient can fill his Medical History form from the patient profile when at the practice assisted by a user.

2. From the Patient Portal

The patients can fill their Medical history forms from the Patient Portal. If the form is in the draft status, the patient will be able to find them in the patient portal Home tab as Pending forms or under the Forms tab.

Related image: ./carestack-questions-2023-03-02_files/1629454753454-pat portal.gif

3. From the Kiosk

Under forms pending completion, you will be able to see the pending forms. So if the Medical History form is in the draft status, you will be able to find it under the pending forms.

Related image: ./carestack-questions-2023-03-02_files/1654060262834-1654060262834.png

Medical Hx form - Spanish

Since a completed Medical Hx. is vital before a patient’s treatment, the difficulty faced by the Hispanic patients to complete the English Medical Hx should be addressed due to the increasing priority and the no: of customers requesting to have this. The Front Office is forced to have a translator to assist a Hispanic patient completing the Medical Hx. thus affecting the resource management and a longer waiting time for the patient before the appointment.

Spanish Medical Hx configuration

Both the Medical Alerts and the questionnaire can be configured in Spanish version for the Hispanic population. While adding a Medical Alert a corresponding Spanish version can be added as a toggle. The English version continues to remain the basic template and the Spanish version is only a carbon copy of the English component (for example, a follow up question cannot be added for a Spanish translation alone, instead it retains the behavior of the English component)

Related image: ./carestack-questions-2023-03-02_files/1654060713458-1654060713457.png

Each question inside the Medical Hx form questionnaire can have its Spanish version and can be configured accordingly inside the Practice Settings for the Medical Hx form.

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Spanish Medical Hx Presentation

Spanish patients can choose to fill a Medical Hx form in the Spanish version for easier convenience. As listed earlier, a Med Hx form can be filled via the PMS, the Patient Portal and the kiosk mode of the Patient Connect.

1. PMS

Related image: ./carestack-questions-2023-03-02_files/1654061513701-1654061513701.png

2. Kiosk Mode & Patient Portal

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Written by Aswathy B Nair | Last published at: July 29, 2022


Promotional campaigns are structured as one-and-done email communications. They are typically used for promotions like specials or coupons, but also for other types of targeted communications like announcements, or insurance letters. 


Promotional Campaigns Landing Page


Promotional campaigns can be seen under System menu > Patient Engagement > Campaigns > Promotional Campaigns. The below given picture shows the landing page of Promotional Campaigns.


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The Search bar helps you to find the campaign easily if you know the name of the campaign beforehand. 

The Location Filter helps you to filter the campaigns by Location. You can select the Location and it will show all the campaigns that have the specified location.


How to Create a Promotional Campaign

You can create a promotional Campaign from Promotional Campaigns Landing Page > Create Campaigns

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Campaign Settings

When you click on Create Campaign, it will take you to the Campaign Settings tab. Let's see the field one by one.

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Hit Next on the bottom left to go to the next tab

Campaign Content

You would be able to set the content for your campaign from this page. You could either use the email templates available or you could create a new template by choosing the Blank Template. You could also click on "Upload HTML" at the top-right to browse for an HTML template saved on your computer.  

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You can try sending yourself a sample message if desired. Just click on Send Sample. But please be aware that the practice name and the organization-based fields would be filled with dummy values and would only populate the right ones when sent to the patients.

Oh, you chose the wrong template? No worries, you can always change the template by clicking Change Template on the top right. A pop-up comes to confirm if you want to change the template. Once you confirm, it takes you to the page where you choose the templates(the landing page of Campaign Content).

Hit Next to go to the next tab

Campaign Recipients

Here you may select to whom you want the campaign to be sent. There are certain existing templates from which you can select or you can create a list of patients or templates of your choice by clicking on 'create the template of your choice' just below the existing templates. On clicking 'create a template', you would get the option to set the conditions just like when we generate a patient list.

Related image: ./carestack-questions-2023-03-02_files/1628600144707-1628600144707.png

*Hit  Next at the bottom-right of the screen to continue.

Summary

The final section is the  Summary tab. This allows you to review any final details before saving and sending out your campaign. 

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Written by Aswathy B Nair | Last published at: August 15, 2021


Curbside check-in is a campaign that gives the ability for patients to come and check in for their appointment from the parking area of the dental office so that they don't have to wait in a public space with other patients. This functionality was introduced to specifically cater to the problems introduced due to the Covid pandemic. 


Curbside check in allows us to send a special text message to the patient before the appointment, letting them know that they can check-in with their phones directly from the parking lot.

When the patient arrives at the parking lot, they simply respond with 'c'. The appointment status will get updated in the Scheduler and the patient will receive an automated response. Thus the patient can wait comfortably in the car until someone from the practice calls or texts that it is time to come in.


Permissions

Before you set up a campaign, make sure that you have the necessary permissions to add/ edit it.

You can set the permissions under System Menu > Practice settings > Administration > Profiles > Manage permissions > Patient Engagement > Campaigns.


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How to set up a curbside check-in Campaign?

You would be able to create or set up a curbside check in campaign by navigating to System menu > Curbside check in

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This will take you to the Curbside Check-in Pop up box where you can enter the details for the set up.

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Let's go through the fields real quick!

  1. Select the appointment locations: You would have to select the locations for which you need to trigger this campaign.
  2. Select the appointment statuses that should trigger the initial text message: Here you would have to choose the appointment status for which you need to trigger the campaign.
  3. Select a new appointment status to display once the patient responds: This is where you choose the new status to be displayed on the appointment once the patient confirms the campaign text with a ‘C’.
  4. This last field is where you set the time when you want to trigger the campaign. By Default, it would be 30 minutes. 

*All these fields would get pre populated if there is an existing Curbside check in Campaign.

Once you enter all the details and click on Save settings you will see an Information pop up box.

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**Note: It will take about 24 hours for the campaign to become active after it has been set up or modified.



How to View a Curbside Check in Campaign


You’d be able to find the campaign under System menu > Patient Engagement > Campaigns > Specialized Campaign.

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Click on the Action Drop down and there you will have the option to view the curbside check in campaign. The View option directly takes you to the Summary of the campaign where you’d be able to see all the information with regards to the Curbside Check in campaign. You could also toggle between the other tabs. 


How to Edit a Curbside Check in Campaign

You’d be able to Edit the campaign under System menu > Patient Engagement > Campaigns > Specialized Campaign > Actions > Edit.

Related image: ./carestack-questions-2023-03-02_files/1628500800647-curb.gif


When a patient replies with ‘C' to their curbside check-in request the following takes place:





Written by Aswathy B Nair | Last published at: August 16, 2021


Recurring campaigns, as the name suggests, are used for repeated communications like reminders and confirmations. Each recurring campaign can have multiple email, text, and/or voice messages delivered at specific intervals as the campaign runs. Once your recurring campaign is set up with your desired generation criteria, you can run the campaign and forget about it; it'll continue to do its job in the background, sending preset messages to your patients for you. Appointment Campaigns are recurring campaigns. There are three kinds of Appointment Campaigns: Appointment Reminders, Appointment Confirmation and Appointment Notification. Lets look into it one by one.


Appointment Reminder Campaigns

Appointment Reminders are campaigns that reminds the patient of an upcoming Appointment. To add an appointment remainder Campaign, you would have to navigate to System menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > Appointment Reminders.

Related image: ./carestack-questions-2023-03-02_files/1628766442492-appointment campaign.gif

This takes you to the Campaign Settings tab. 

Campaign Settings

Here you would have to enter the Basic Details of the campaign.


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Hit Next on bottom left to go to the next tab


Campaign Content

You would be able to set the content for your campaign from this page. You could either use email templates available or you could create an new template by choosing the Blank Template. You could also click on "Upload HTML" at the top-right to browse for an HTML template saved on your computer.  

Related image: ./carestack-questions-2023-03-02_files/1628720494658-1628720494658.png

Did you see Add medium on top right? Yea, you guessed it right! It is used to add mediums like text , email and voice. From the dropdown, you can choose the medium by which you want to send the campaign. You also have an option to remove a medium. If you click on Remove Medium, you will have the option to choose the medium from the start.

Related image: ./carestack-questions-2023-03-02_files/1628720852037-1628720852037.pngWhen you choose the template, you would be taken to a page where you can make changes to the existing template, make edits or add a link etc.

The most important thing here is the option which allows us to set the time of the campaign. Here you would be able to set the time, in days, hours or minutes, by which you like the campaign to be sent before the appointment. 

Related image: ./carestack-questions-2023-03-02_files/1628721392126-1628721392126.png


You can try sending yourself a sample message if desired. Just click on Send Sample. But please be aware that the practice name and the organization based fields would be filled with dummy values and would only populate the right ones when sent to the patients.

Oh you chose the wrong template? No worries, you can always change the template by clicking Change Template on top right. A pop up comes to confirm if you want to change the template. Once you confirms, it takes you to the page where you choose the templates(the landing page of Campaign Content).

Hit Next to go to the next tab

Campaign Recipients

Here you may select to whom you want the campaign to be sent.

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Campaign Criteria

You can set the Campaign Criteria from here and note that the campaign would only go to those patients who satisfies the criteria of the campaign.

Family Appointments

You can choose to send the campaigns either to each patient in a family account separately or merge the appointment details of all the campaigns sent to a single phone number.

Note:


Summary

After setting the Campaign criteria, you can click Next, which would take you to the last tab.

Here you would be able to see all the information that we have entered regarding the campaign. This is the best place where you can check all the details that you have entered before you could save and enable the campaign. 

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Appointment Confirmation Campaigns


Appointment Confirmation Campaigns are send to patients for them to confirm their upcoming appointments. This way the practice can make sure that the patient would be coming to the practice for the treatment. To create an appointment confirmation campaign you could navigate to System menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > Appointment Confirmation.

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This would take you to the Campaign Settings tab.


Campaign Settings

Here you have to fill the Basic details of the campaign just like we did for Appointment Remainder campaign. Give it a try yourself, lets see how much you recall!

Yes, you have to enter the Name, Description, Locations and Branding. All the field would have default values prepopulated as in the screenshot below but you are always free to change the contents according to your will. On clicking the Next button, you will land in the Campaign Content tab.

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Campaign Content

Similar to Reminder campaign, you can choose a template or can create one of your ow. You can also upload HTML files from your system using Upload HTML. You can add mediums or remove them from here.

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When you select a template, you would be taken to the page where you can edit the campaign content. 

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Campaign Recipients

Related image: ./carestack-questions-2023-03-02_files/1628768059406-1628768059406.png

You can set the campaign criteria here just like we did for Appointment Reminder Campaigns.

Family Appointments

You can choose to send the campaigns either to each patient in a family account separately or merge the appointment details of all the campaigns sent to a single phone number.

Summary

After setting the Campaign criteria, you can click Next, which would take you to the last tab.

Here you would be able to see all the information that we have entered regarding the campaign. This is the best place where you can check all the details that you have entered before you could save and enable the campaign. 


Related image: ./carestack-questions-2023-03-02_files/1628768205659-1628768205659.png



What happens when a patient confirms an appointment?

When a patient confirms an appointment either through text or email campaign,


Appointment Notification Campaigns


Appointment Notification campaigns are send to the patients after the appointment inorder to thank the patients for visiting the practice and or even some measures to be taken after the services rendered.

To create an Appointment Notification campaign, you would have to navigate to System menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > Appointment Notification. This would take you to the campaign settings.

Related image: ./carestack-questions-2023-03-02_files/1628784486431-1628784486431.png

The campaign settings are similar to that of Appointment Reminder and Appointment Confirmation Campaigns. 

Campaign Content

In the campaign content, you can select the template, add medium or remove one. Once you select the template, you would be taken to the page where you can edit the contents and make changes if you please. 


Related image: ./carestack-questions-2023-03-02_files/1628784827037-1628784827037.png


You can enter the Email subject and also confirm the number of after before the appointment to send this campaign. So the important difference that you see here is that the Appointment Notification campaigns are sent after the appointment.

Campaign Recipients

Just like in the other appointment campaigns, you have to set the criteria for the campaign to get triggered. Since the campaign is sent after the appointment, the trigger status would be probably Checked out. 

Related image: ./carestack-questions-2023-03-02_files/1628785513609-1628785513609.png

Summary

Here you would be able to see all the information that we have entered regarding the campaign. This is the best place where you can check all the details that you have entered before you could save and enable the campaign.

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Written by Aswathy B Nair | Last published at: August 16, 2021


Both New Patient Greetings and Birthday Greetings are the campaigns sent to the patient to show the hospitality of the practice, to show that they care for their patients. New patient greetings are sent to the patients once they come to the practice for the first time and Birthday greetings, as the name suggests, is sent out on the Birthdays of the patients.


New Patient Greetings


As discussed above, the New Patient Greetings are sent out to the patients to welcome the patients to the practice. Through this campaign, the practice usually sends the patient portal link so that the patient can fill the forms (like the onboarding forms) from the link.

To create a New Patient Greeting, you can navigate to System menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > New Patient Greeting.

Related image: ./carestack-questions-2023-03-02_files/helpjuice_production_uploads_upload_image_9675_direct_1628850009888-new+pt.gif

Campaign Settings

You can enter the Basic Details of the greetings here like the Name, Description, Locations and Branding.

Related image: ./carestack-questions-2023-03-02_files/1628849935769-1628849935769.png

You can click 'Next' to navigate to the next tab.

Campaign Content

Here, on the landing page of the Campaign Content, you will have the opportunity to choose the email template. Once you select the templates, you would be taken to the page where you can make changes to the existing template.

Related image: ./carestack-questions-2023-03-02_files/1628855222345-content.gif


Once you click 'Next', it takes you to the Summary Tab.

Summary

On the Summary tab, we would be able to see details of the campaign. You can verify the details and make changes if required.


Birthday Greetings


Wouldn't the patient be happy if they see that you remember their birthday! Of course they will be. Who doesn't love Birthday Wishes?

CareStack helps you wish patients' birthday, even if you forget them. This is the purpose of Birthday Greetings.

To create a Birthday Greeting you have to navigate to System menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > Birthday Greeting

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Campaign Settings

Just like we did in New Patient Greetings, fill all the necessary fields in this page. All the fields would be filled with default values and you can make changes if you would like to.

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When you click 'Next', it will take you to the Campaign Content page.

Campaign Content

Here, on the landing page of the Campaign Content, you will have the opportunity to choose the email template. Once you select the templates, you would be taken to the page where you can make changes to the existing template.


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Summary

On the Summary tab, we would be able to see details of the campaign. You can verify the details and make changes if required.

Written by Aswathy B Nair | Last published at: August 16, 2021


Bringing patients back to your office is important for them and for the practice. Patients need regular treatments to maintain their health, and you need the steady stream of patient visits. Recalls are generally used for this purpose.

Recall campaigns are reminders sent to the patient regarding their recalls. Let's see how we can create a recall Campaign.

You can add a new Recall campaign by going into System Menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > Automated Recalls.

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Campaign Settings

When you select Automated Recall from Create Campaign, you would be take to the Campaign Settings page. In this page, you would have to fill the Basic details.

Once you fill all the details in this tab, you can click Next which will take you to the next tab.


Campaign Content

You would be able to set the content for your campaign from this page. You could either use email templates available or you could create an new template by choosing the Blank Template. You could also click on "Upload HTML" at the top-right to browse for an HTML template saved on your computer. When you select the template, you will be taken to the page where you will be able to edit the contents of the template.

Are you wondering if you can use only email templates? No way, you can have them sent as text as well. You just need to click on Add Medium on top right and it will give you an option to add other mediums. You also have an option to remove a medium. If you click on Remove Medium, you will have the option to choose the medium from the start. Once you choose all the templates and set the time by which you want the campaign to get triggered, you can click Next.


Campaign Recipients

On this tab, you can set for whom the campaign should be triggered. There are certain existing templates from which you can select or you can create a list of patients or template of your choice by clicking on 'create template of your choice' just below the existing templates. On clicking 'create a template', you would get the option to set the conditions just like when we generate a patient list.

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Set Recall Criteria

You can select the recalls for which you want the campaign to be sent. This can chosen from the dropdown list in Recall Type. This Recall type is actually reflected from those set under System menu > Practice settings > Codes > Recalls.

We can choose patients with specific recall codes or patients that have overdue recalls in the next 3 months. This can be completely configured according to the practice's criteria. 

Family Appointments

You can choose to send the campaigns either to each patient in a family account separately or merge the appointment details of all the campaigns sent to a single phone number.

Note:

Once all the fields are filled with the desired criteria, you can click Next.


Summary

Here you would be able to see all the information that we have entered regarding the campaign. This is the best place where you can check all the details that you have entered before you could save and enable the campaign. 

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Written by Aswathy B Nair | Last published at: August 16, 2021


Bringing back inactive patients is very important for a practice. Inorder to engage the inactive patients, we can set up Patient Re-Engagement Campaigns.These campaigns are sent to patients after a specified time after their last checked out appointment. 

You can add a Patient Re-Engagement campaign by going into System Menu > Patient Engagement > Campaigns > Recurring Campaigns > Create Campaign > Patient Re-Engagement.

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When you select Patient Re-Engagement from Create Campaign, you would be take to the Campaign Settings page. In this page, you would have to fill the Basic details.

Campaign Settings

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Once you fill all the details in this tab, you can click Next which will take you to the next tab.

Campaign Content

You would be able to set the content for your campaign from this page. You could either use email templates available or you could create an new template by choosing the Blank Template. You could also click on "Upload HTML" at the top-right to browse for an HTML template saved on your computer. When you select the template, you will be taken to the page where you will be able to edit the contents of the template.

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Do you want the campaign to be sent in any medium other than email? You just need to click Add Medium on top right and it will give you an option to add other mediums. You also have an option to remove a medium. If you click on Remove Medium, you will have the option to choose the medium from the start. Once you choose all the templates and set the time by which you want the campaign to get triggered, you can click Next.

Summary

Here you would be able to see all the information that we have entered regarding the campaign. This is the best place where you can check all the details that you have entered before you could save and enable the campaign.

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Written by Sarah Abraham | Last published at: August 16, 2021


Overview
Reputation management allows the user to collect reviews and user feedback that helps better the overall dental experience. 
Setting up Reputation Management

Reputation management can be set up by navigating to Patient Engagement > Reputation Management. 
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Under setup  tab, the user can choose to select the mediums for review. We currently provide Google, Yelp, Facebook reviews along with Carestack reviews.

The practice can choose the branding that would suit their business. Global branding allows the reviewers to see the account details whereas group branding provides the flexibility to cluster the different locations under one brand. The practice can also choose to brand at a location level.

Automatic Review Requests

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We have an option to send manual requests as well as automatic requests for review to patients. To set automatic requests the option 'Send review requests automatically after every appointment ' should be set to 'Yes'.

If this has been done, the user has to choose locations for which automatic review requests has to be sent. We do provide the functionality to send both email and text. Text can be enabled only upon a service request from the client.

For locations that have automatic requests set up, every time an appointment is checked out, a review email or text is sent to the patient. The template of the mail sent is similar to the one shown in above image. 

The user also has an option to choose the time period after which the review has to be sent. By default this is 5 minutes. So the review is sent to the patients 5 minutes after the appointment is checked out. 

Here we have to note only those patients with notifications enabled will receive the request. 

Manual Requests

The locations that aren't chosen for automatic requests can be used for manual requests. In this case, the locations which are chosen for manual requests will have a new option namely , 'Send manual requests' in the appointment context menu. 

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Upon choosing this option, immediately a mail or text is sent to the patient. 

Review
The user will receive either a mail or a text. The format of the mail is similar to the one shown below

Related image: ./carestack-questions-2023-03-02_files/1629093964619-1629093964619.pngClicking on 'Give us a feedback', the user is taken to Carestack review page. Here the user can submit a review as well as leave their comments as feedback. 
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Dashboard

All Carestack reviews that are provided by the patients would be listed on the dashboard. The current location of the user would be selected by default and the user can further choose any location or all locations from the filter.

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Also, the user is provided details like the total number of review, Aggregate rating and a breakup of the review according to the rating as well as the rating distribution. 

The user also has the option to sort the entries either by Latest first, oldest first, highest or lowest level rating. 
Also to view the entire comments, the user can clicK the 'View Details' option.

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Written by Abhishek Vijay | Last published at: August 15, 2021


The heart of the patient engagement workflows of CareStack, the Dashboard. Here is where all the campaigns, their content, their set up, and the status of delivery of the same are all housed.

The dashboard provides a summarized data around patient engagement campaigns so that the user can quickly evaluate the effectiveness of the campaigns and access detailed information if needed.

We can navigate to the Patient Engagement Dashboard by navigating to the same through the System Menu.

System Menu > Operations > Patient Engagement

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As you can see above, there are multiple sections, campaigns, and functions over here. Let's go through them one by one.


Overview

The overview is the first screen that greets us when we navigate towards the Patient Engagement section through system menu. 

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The overview presents us with a graphical representation of the confirmed appointments via the campaigns sent. It also gives us the approximated production expected from those appointments, and the confirmation response percentage.

Towards the right of this screen, we have the ability to set and view the data displayed on the dashboard according to a date-range and location combination that we can select from a drop-down menu. 

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We also have an 'update' button to the right of these drop-downs, and on clicking it data should be displayed for the corresponding combination of location and date. The update button can be disabled if there is no location selected from the drop-down.

By default, the user is navigated to the view with location set as the default location of the user, and date range as "last 7 days". The max number of locations that we can select at a time will be 30.

The date range drop-down should have these options:



On the right, we have 3 sections, that has the details about the emails and texts sent as campaigns. The sections are Promotional Emails, Recurring Campaigns and Reputation Management.

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You also have an option to download the data about the patient activity and the campaign activity as well.

At the bottom, we have the details about the main four campaigns that we have, Appointment Confirmations, Appointment Reminders,  Appointment Notifications, and Recalls.

From this tabular representation, you can get an idea about the modes of communication sent, responded, and in some cases, opted out by the patient, at a glance.

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The data represented would be T-1, that means the data being displayed is a day behind, showing the count till yesterday end.

Written by Abhishek Vijay | Last published at: August 16, 2021


You might have noticed by now that the content inside an active campaign is mostly pre-filled on a client's site. How and where is all this change made, and how can it all be altered?

Similar to creating a template for texts and memo, we have the option to create templates for Texts, Emails and Voice models to be used inside a campaign. Once these templates are created, we can simply add them with a click into a campaign.

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Let's now have a look at the workflow to create each template.


Text Templates



To send an alert to a patient via a text, CareStack has the ability to add pre-set templates into the campaigns. The text templates can be newly added, edited and even deleted as per the wish of the practice.

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Adding a Template

To add a text template. we may simply select the add option present at the top right. Upon adding a new template, we can notice a few fields as well that require data to be entered. Let's have a detailed look at the same.

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Editing a template

To edit an existing template, we can just click on the template field to bring up the edit option, and once we click on edit, we can make the necessary changes as well.

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Deleting a template

To delete a template, we have to select the checkbox corresponding to the required template and then under the Actions tab at the far right, you would have the option to delete. 

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Email Templates



Creating, editing and deleting an email template is very similar to that of a text template. Here we have the added option of adding pictures, links, buttons to be assigned to an action or even tables.

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Moreover, we have the option to import HTML documents directly into our templates, with the Upload HTML button at the top right.

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The procedure to adding an email template is very similar to that of the text template, with the exception of the ability to add external media content into the template.

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To edit or delete an existing email, the procedure is again similar to that of the text templates.

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Voice Templates



CareStack has the added advantage of adding templates as voice models, which serve a similar purpose to that of the text and email templates, but in an audio form. The client would receive a call from the practice, and the audio transcription of our text input is being read out.


The creation process is similar to the process for text and email templates. The text that is entered into the template would be transcribed into an audio form that is sent to the patient as an audio file. We also have an option to add a separate message to be read aloud in case the call is missed and goes to voicemail.

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Similarly the procedure to edit and delete the template is possible by clicking into field and clicking edit as well as selecting the template and selecting the delete option under Actions respectfully.

Written by Athul V Suresh | Last published at: October 07, 2022


Overview  


The Deposit slip report is used to track all payment transactions. This report is used to reconcile the total amounts collected for the different types of payment deposits received. It shows a record of receipt entries that have payment categories as Cash, Card, and check. It will help the practice determine how much money has been deposited in their bank.

The report shows real-time data. The report can be generated by either payment category or payment type. The Deposit slip shows a consolidation of the payments deposited through the selected payment category or payment type(as selected in the view) to your practice and lists out the count, patient amount, insurance amount, collection agency amounts, and total collection received. It also has a totals row for the consolidation across the different payment categories/ types. The deposit slip shows separate entries for each receipt that is added in the practice within the selected date range.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Date As* 

Decide whether to include receipts in the report that has payment date/transaction date within the selected date range. Only receipts with the transaction date within the selected date range will appear when the date as option is set to the transaction date. Only receipts with the payment date within the selected date range will appear when the date as option is set to the payment date. By default, the payment date is selected.

View by*

Select this option to choose to view your report either by payment category or payment type. When you choose to view this report by payment category/payment type you will be able to see all receipts that have been added under each payment category/payment type under a consolidated view and the details pertaining to each individual receipt.

Date Range*

Deposit slip report is dated by transaction date or payment date as selected in Date as filter. The date range can be selected for a maximum of 1 month. By default, the date range will be for the current day.

Location*

Select a location or locations to focus the report on the receipts in the selected location(s). By default, the location will be the user’s default location.

Payment category

Select this option to focus your report on the payment category. the payment categories that are considered for this report are Care Credit, Cash, Check, Credit/Debit card, and direct transfer. By default, Cash and Check are selected.

Payment type

Select this option to focus your report on the payment types in your practice Only payment types with categories set as Care Credit, Cash, Check, Credit/Debit card, and direct transfer will be available for the report.

Payment entity

Select this option to focus your report on the payment entity of the receipts, either patient, insurance, collection agency or all of them. Depending on the options you choose you will be able to see further criteria options to choose the patient, carrier, collection agency.

Patient

Choose to focus the report based on the selected patients.

Carrier

Choose whether to focus your report on only the selected carrier(s).  

Collection Agency

Choose whether to focus your report on only the selected collection agency(s). 

Columns*

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting 


The default sorting for Deposit Slip report is by transaction date (asc). Sorting is possible on payment date, deposit date, amount, and unapplied columns as well.

Results


View by payment category:Related image: ./carestack-questions-2023-03-02_files/1628685166098-1628685166098.png


View by payment type: Related image: ./carestack-questions-2023-03-02_files/1628685188951-1628685188951.png


The deposit slip report has two sections- the first is the consolidated totals and the next section is the detailed receipt section. The results columns shown in this report include:

Consolidated Section

Payment Category 

The category of payment, whether it was made via Cash, Credit Card, Check, and so on.

Payment Type  

The payment method of the receipt like the type of credits card accepted in the practice and other payment sources with payment category as mentioned above.

Count 

The number of payments made on the selected date range via this payment category/ payment type.

Patient 

The total dollar amount received from patient payments on the selected date range via this payment category/ type. 

Insurance 

The total dollar amount received from insurance payments on the selected date range via this payment category/ type. 

Collection Agency 

The total dollar amount received from collection payments on the selected date range via this payment category/ type.

Total 

The total dollar amount received from patients, insurance carriers, and collection agency on the selected date range via this payment category/ type. 

Detailed Receipt Section 

Payment Entity 

The type of payment accepted whether it was a patient payment, insurance payment, or a payment made by a collection agency.

Payment Date 

The date on which the payment was accepted according to the Payment Date specified on the receipt.

Transaction Date 

The date on which the payment was deposited according to your system records.

Deposit date 

The date the insurance payment was deposited by your office.

Source 

The source of the payment, whether the payment was made by the specified insurance carrier, collection agency, or patient. 

Receipt 

The system-assigned number used to identify the payment that has been entered into the system. Click this hyperlink to be taken to the receipt details. 

Location 

The location pertaining to the payment that has been deposited. 

Payment Categor

The category of payment, whether it was made via Cash, Credit Card, Check, and so on.

Payment Type 

The method of payment, whether the payment was made via Visa, Master Card, Cash, Check, and so on. 

Reference Number 

The reference number entered by your office staff member while accepting the payment. 

Amount 

The total dollar amount of the payment made. 

Unapplied 

The dollar amount that remains unapplied on the payment receipt after any credits have been posted from the receipt.

Last Updated By 

The name of the user that last updated/ edited the receipt.

Permissions


Permissions for the Deposit Slip report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Deposit Slip Report. Only users with Generate Deposit Slip Report permission set as Yes will be able to generate the report.


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Written by Athul V Suresh | Last published at: September 28, 2021


Overview


The Daily journal report is used to see the daily productions and collections. The report can be used to see compare the codes that have been completed for the day and receipts that have been added for the day.

The report gives the user a comprehensive idea of the daily transactions and diverts the attention to potential areas that the practice loses money on. The report shows real-time data in two views- summary view and detail view.

All dates are based on the transaction date. The summary view shows the consolidated total production and collection for the date range selected. It also shows the payment summary which shows the unapplied payments within the selected date range, the applied payments in the selected date range, and the applied payments in the selected date range from receipts that were added prior to the selected. date range. The user can also see the total applied payments from the payment summary. You also have the flexibility to see the daily collection and production grouped by either provider or location. The detailed view gives the patient level drill down on each action the user performs.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the daily journal summary view report, your filter options include.

Group By*

Decide whether to group your report results by Provider or Location. The location specified will be the treatment location for the completed codes and the receipt location for all the receipts that have been added to the system. By default, Provider will be selected.

Date Range* 

Select this option to focus your report on transactions and completed codes made within your selected date range. The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day. 

Provider

Select this option to focus your report based on the selected treatment provider(s).

Location*

Select this option to generate your report data based on transactions and completed codes made at the selected location(s). By default, the location will be the user’s default location. 


Detail view

For the daily journal Detail view report, your filter options include:

Date Range*

Select this option to focus your report on transactions and completed codes made within your selected date range. The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day.

Provider

Select this option to focus your report based on the selected treatment provider(s).

Location*

Select this option to generate your report data based on transactions and completed codes made at the selected location(s). By default, the location will be the user’s default location. 

Action

Select this option to choose the action of the transaction done (whether a code was completed or deleted, or the fee was updated, a payment was made or the receipt refunded, and so on).

User

Select this option to focus your report to display only on the transactions or completed codes or both, made by the selected user.

Patient flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Group By* 

Choose to group by location, provider or patient. By default, 'None' is selected. 

Group By Action and Show total check box

Click on this check box to show the total UCR fee, Gross production, Insurance amount, Patient amount, Unapplied amount grouped by each action.

Columns*

Choose the columns you wish to see in this report. By default, 10 of the most relevant columns will be selected.

Sorting


The default sorting for Daily Journal report is by transaction date (asc). Sorting is possible on DOS, Deposit date, UCR Fee, Gross Production (Trans. Date), Ins Amt, Pat Amt, and Action columns as well


Results


Summary View

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The report provides information in column form grouped by either provider or location.

The first section of the summary view contains the consolidated total of all productions and collections of all the selected locations. The first section shows the UCR fee, Pat. amount and Ins. Amount and Total Amount of the following.

Completed codes- The codes that have been completed in the selected date range in the selected location.

Fee updates- The fee updates that have been made for the completed codes. If the total fee is an update made in the selected date range is less than the total estimated fee then the amount will be displayed in red color inside closed brackets.

Deleted Codes- The dollar amount of balances removed when these procedure codes were deleted out of the system. The amount will be displayed in red color inside closed brackets.

Production Adjustments- The dollar amount of production adjustments made against an outstanding balance, either to increase or decrease the amount of production generated. If the total Adjustment is a negative amount then the amount will be displayed in red color inside closed brackets. 

Migrated production- The total migrated production from the practice's previous software.

Total (Net Production)- The dollar amount of production generated plus/minus any production adjustments made. 

The next section inside the consolidated grid shows the net collections from receipts in the selected date range 

Receipts- The dollar amount of payments that have been accepted and entered into the system. 

Deleted Receipts- The dollar amount of payment receipts that have been deleted out of the system. The amount will be displayed in red color inside closed brackets to indicate a negative transaction. 

Receipt Updates- The total dollar amount involved in receipts that were updated, in the instance that the payment amount on an insurance receipt is updated (for example, the receipt was made for $100, but then the receipt was updated to reflect a payment of $120). If the total receipt update is a negative amount then the amount will be displayed in red color inside closed brackets. 

Refunds- The dollar amount of payments that have been refunded to the payer. The amount will be displayed in red color inside closed brackets to indicate a negative transaction.

NSF Receipts- The dollar amount of payment receipts that have been marked as Non-Sufficient Funds. The amount will be displayed in red color inside closed brackets. Even if the NSF is reversed the amount in the check that was marked as NSF will still be displayed here.

Reverse NSF Receipts- The total dollar amount involved in receipts that were reversed due to nonsufficient funds. 

Collection Adjustments- The dollar amount of collection adjustments made against an outstanding balance, either to increase to decrease the receivable. If the total Adjustment made is a negative amount then the amount will be displayed in red color inside closed brackets. 

Over Payment Recovery- The dollar amount involved in overpayment recovery from insurance receipts.

Total (Net Collection)- The dollar amount of receivables collected after any collection adjustments made. 

Transaction charges- The transaction charges associated with payment types like care credit.

Total- The total dollar amount of the transaction charges.

Payment summary- The payment summary sections inside the consolidated total show the applied payments and unapplied credits in the selected date range.

Unapplied Payments (current)- The unapplied payments from receipts added within the selected date range.

Applied Payments (Current)- The credits applied to codes from receipts added within the selected date range.

Applied Payments (Prior)- The credits that have been applied to codes from receipts that have been added before the selected Date Range.

Total Applied payments- The total applied payments in the selected date range.

The next sections inside the summary view are Grouped by provider or location depending on the group by option the user selects.

If the user chooses to group by provider then the section after the consolidated total will be the net productions and collections mentioned above for each provider. For each section of the provider, the net collection and production will be shown for each location and the provider total.

If the user chooses to group by location then after the consolidated total, the net production and collection will be shown for each location. For each section of the location, the net collection and production will be shown for each provider.

Detailed View.

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The results columns shown in this report include:

Transaction Date

The date the code was marked as completed in the system or the date the receipt was added to the system. 

Patient Name

The name of the patient to which the transaction applies, whether it was a completed code, refund, deleted receipt, or so on. 

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the ledger of the patient's profile.   

D.O.S

The date on which the patient was seen by their treatment provider for the completion of these services. 

Deposit date

Date of deposit of insurance check.

Code Description

The procedure code name along with its description. 

Tooth/Area 

The Tooth/Area on which the procedure code was done.

Surface

The surface of the tooth to which the procedure code applies. 

Location 

The treatment location for the listed procedure code or receipt. 

Provider

The treatment provider applicable to the listed procedure code or receipt. 

UCR Fee

Your office's standard fee for this procedure code according to your practice settings. 

Gross Production (Trans. Date) 

The dollar amount pertaining to the transaction completed, or the total fee of the procedure code at the time of check-out. 

Insurance Amount

The insurance payable at the time of code completion. 

Patient Amount

The patient payable at the time of code completion. 

Action

The action of the transaction done (whether a code was completed or deleted, or the fee was updated, a payment was made or the receipt refunded, and so on) 

Payment Method

The method of payment accepted or refunded, whether it was made via Visa, Master Card, Cash, Check, and so on. 

Carrier

The insurance carrier to which the payment, refund, or adjustment applies. 

Receipt #

The system-assigned number is used to identify the payment that has been entered into the system.

Unapplied

The dollar amount on a receipt remains to be applied towards any outstanding charges. 

User's Name

The name of the user that completed the transaction in the system. 

If the show total check box is applied then the detailed view report will be grouped into sections depending on the actions. The report will have entries grouped by actions like completed codes receipt addition receipt deletion and so on.

Use Case


The report can be used to get a detailed idea of all transactions that happen in the practice. The ability to see the transactions that happen grouped by each action helps the practice to have a clear idea of the productions and collections in the practice.

The daily journal report is also a useful tool to map the daily provider production. This helps the practice determine the exact revenue produced from each provider.

Permissions


Permissions for the Daily Journal report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Daily Journal Report. Only users with Generate Daily Journal Report permission set as Yes will be able to generate the report.


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Written by Athul V Suresh | Last published at: August 23, 2021


Overview


Claims report is used to track the claims that have been generated in the practice. This report lets the user know the claims that require attention, the claims that have been sent out and are yet to hear back from the carrier, the claims that have been rejected, and so on.

The Claims Report can be used to view the expected insurance production from each carrier for the claims sent out, the claim status outstanding balance, and so on. This report shows real-time data and is available in two views- Summary and Detail view. 

The summary view shows the total outstanding dollar amount and number of all claims that have remained unpaid in different aging buckets. The users have the flexibility to group the report by either carrier or claim status and allows them to see outstanding amount by each carrier or in each claim status like acknowledged (payor), finalized(payor), On Hold, and so on. Moreover, the user can also choose if the aging buckets should be based on the submitted date or the DOS of the claim. The detail view shows the drill-down information of each claim including details like claim ID, patient ID, the carrier, plan, estimate fee, insurance paid amount, outstanding fee, and so on.  

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the Claims Summary View report, your filter options include: 

Group by*

Select this option to group your report on either Carrier or claim status. When you choose to group by carrier the report is based on each carrier and the total outstanding dollar amount for claims sent to each carrier is divided into aging buckets. Similarly, when you choose to group by claim status the report is based on claim status and the total outstanding dollar amount for claims in each status is divided into aging buckets. 

Carriers list*

This filter is only available when you group by carrier. Choose to view your report on either the top 10 carriers or all of the carriers in your practice. The default will be the top 10 carriers

Date As*

Decide whether to date your report results by Aging Days or Creation Date of the claim. If you choose to date as Aging date then all claims other than the ones in closed status and voided status will be considered and their outstanding amount grouped into corresponding aging buckets. If you choose to date as Created date then you will have to choose the date range. Only claims that are created within the date range selected will be considered for the report.

Aging based*

Select this option to choose the aging bucket calculation based on the date of submission of the claim or the DOS of the claim.

Aging Days

Select this option to choose whether to generate data based on claims that have been aging within the last 30 days, 31-60 days, 61-90 days, 91-120 days, or over 120 days. 

Date range

If generating this report based on the creation date, select the intended date range. Select a maximum of up to 6 months. 

Location*

Select this option to focus the report on the claim's location. The default location will be the user's default location.

Claim Status

Select this option to focus your report on generated claims currently in the selected status(es). 

Claim Flag

Select this option to focus your report on generated claims with the selected claim flags.

Plan Types

Select this option to focus your report data based on the claims with selected type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on. 

Carrier

Select this option to focus your report on only the claims with the selected carrier(s).

Provider

Select this option to focus your report on only the selected Billing provider(s).

Outstanding Amount >=*

Focus the report on unpaid claims billed out for an amount that is greater than or equal to the dollar amount you specify here. 

Detail View

For the claims Detail View report, your filter options include:

Date As*

Decide whether to date your report results by Aging Days or Creation Date of the claim. If you choose to date as Aging date then all claims other than the ones in closed status and voided status will be considered and their outstanding amount grouped into corresponding aging buckets. If you choose to date as Created date then you will have to choose the date range. Only claims that are created within the date range selected will be considered for the report. 

Aging based*

This field is only available when Aging Days is selected for the Date as filter. Select this option to choose the aging bucket calculation based on the date of submission of the claim or the DOS of the claim. 

Location*

Select this option to focus the report on claims generated at the selected location(s).  

Claim Status

Select this option to focus your report on generated claims currently in the selected status(es). 

Claim Flag

Select this option to focus your report on generated claims with the selected claim flags.

Plan Types

Select this option to focus your report data based on the claims with the selected type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on. 

Carrier

Select this option to focus your report on only the claims with the selected carrier(s).

Provider

Select this option to focus your report on only the selected treatment provider(s).

Outstanding Amount >=*

Focus the report on unpaid claims billed out for an amount that is greater than or equal to the dollar amount you specify here. 

Columns* 

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


The Claims report can be sorted by First submitted date, Last submitted date, DOS, Billed Amount, Insurance amount, Insurance paid, outstanding amount, last updated date.

Results


Summary view

The report shows information in column form grouped by carrier or claim status as selected. It also shows the consolidated values of each location selected on top if more than 1 location is selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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The results columns shown in this report include:

Location 

The location the claim was created. 

Carrier 

The insurance carrier to which the claim was submitted. 

Status 

The current status of the claim, whether it has been Acknowledged by the carrier, Rejected, Partially Paid, and so on.

0-30(#) 

The outstanding dollar amount of claims that have remained unpaid for 30 days or less (along with the total number of these claims). Click this hyperlink to view a Detail Report listing these claims and their details. 

31-60(#) 

The outstanding dollar amount of claims that have remained unpaid for at least 31 to 60 days (along with the total number of these claims). Click this hyperlink to view a Detail Report listing these claims and their details. 

61-90(#) 

The outstanding dollar amount of claims that have remained unpaid for at least 61 to 90 days (along with the total number of these claims). Click this hyperlink to view a Detail Report listing these claims and their details. 

91-120(#) 

The outstanding dollar amount of claims that have remained unpaid for at least 91 to 120 days (along with the total number of these claims). Click this hyperlink to view a Detail Report listing these claims and their details.

Over 120(#) 

The outstanding dollar amount of claims that have remained unpaid for more than 120 days (along with the total number of these claims). Click this hyperlink to view a Detail Report listing these claims and their details.   

Grand Total(#) 

The total outstanding dollar amount of all claims that have remained unpaid (along with the total number of these claims). Click this hyperlink to view a Detail Report listing these claims and their details. 

The report also has a totals row “Grand Total” that shows the total outstanding dollar amount of all claims that have remained unpaid (along with the total number of these claims)  in each bucket.

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these claims and their details.

Detail view

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The result in the Claims detail view report include : 

Location  

The treatment location for which the insurance claim was generated 

First Submitted Date  

The date the claim was submitted to the insurance carrier.

Last Submitted Date 

The date the claim was last resubmitted to the insurance carrier.

D.O.S 

D.O.S of the claim is the date in which the patient was seen by their treatment provider for the completion of these services. if there are procedure codes with more than 1 DOS  then the DOS of the first procedure code is taken.

Claim aging Days 

The number of days this claim has remained unpaid. 

Claim ID 

The system assigned number used to identify the unique claim that has been generated. Click this hyperlink to view the insurance claim details.

Patient Name 

The name of the patient to which this claim pertains.

Patient ID 

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Claims page of the patient's profile. 

D.O.B 

The patient's date of birth according to the information specified on their patient profile. 

Subscribe

The name of the subscriber listed on this patient's insurance plan. 

Subscriber ID / SSN 

The subscriber's ID or social security number is used to identify the subscriber and their coverage.

Service Type 

The type of dental services provided to this patient. 

Billed Amount 

The dollar amount billed to insurance based on the total UCR fees of the procedure codes included on the claim. 

Insurance Amount 

The expected insurance receivable for the procedure codes included on the claim. 

Insurance Paid 

The amount the insurance carrier has paid towards this claim so far. 

Paid Date 

The date the insurance payment has been applied toward the claim. 

Outstanding Amount 

The dollar amount that remains unpaid on this claim. 

Claim Status 

The current status of the claim, whether it has been Acknowledged by the carrier, Rejected, Partially Paid, and so on. 

Mode 

The mode in which the claim was submitted, whether it was electronically or by paper. 

Claim Order 

The order of the claim, whether it was the primary claim submitted to the primary dental insurance, primary medical, secondary dental, and so on. 

Provider 

The treatment provider pertaining to the procedures included on the insurance claim. 

Provider TIN / NPI 

The treatment provider's unique identifier number used to distinguish the eligible clinician. 

Carrier 

The insurance carrier to which the claim was submitted.

Carrier ID 

The carrier identifier number used to route an electronic claim to the correct destination (i.e. insurance carrier). 

Phone Number 

The phone number used to reach the insurance carrier (as entered in the insurance details in your practice settings). 

Group Number 

The group number used to identify this patient's insurance plan. 

Plan Name 

The name of the plan under which this patient has insurance coverage. 

Plan Type 

The type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on. 

Remarks 

The most recent remarks that have been included on the claim. 

Last Updated On 

The date the claim has been last updated. 

Last Updated By 

The user that last updated the claim.  

Permissions


Permissions for the Claims report will be in System Menu -> Practice Settings -> Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Claims Report. Only users with Generate Claims Report permission set as Yes will be able to generate the report.

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Written by Athul V Suresh | Last published at: September 28, 2021


Overview


The Refer out report is used to track the patients that were referred out in the selected time frame. This will let the practice keep track of all the referred out patients. The report shows real-time data in a single view.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Date Range*

Generate Refer Out data based on your selected date range. Select a maximum of up to 6 months. By default, the date range will be for the current day.

Location*

Select this option to focus the report on patients that were Referred-Out from the selected location(s). By default, the location will be the user’s default location. 

Referred By

Select this option to focus the report on Refer-Outs generated by the selected in-house provider(s). 

Referral To

Select this option to focus your report on Refer-Outs made to the selected recipient. 

Referral Provider

Select this option to focus your report on Refer-Outs made to the selected referral provider(s). 

Referred to Specialty

Select this option to focus your report based on the specialty of the referral provider.

Patient Flag

Select this option to focus the report only on patients that have the selected patient flag associated with their profile. Leave the option All to find ReferOuts for all patients, regardless of their flags.

Patient

Select this option to focus the report only on the selected patients.

Columns*

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


The default sorting for Refer Out report is by referral date(desc). Sorting is possible on Last Visit, Exp. Visit and Next Visit columns as well.

Results


The report gives the drill-down of each refer out.

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The results columns shown in this report include:

Referred To 

The recipient provider to which the patient was referred out. 

Specialty 

The specialty of the referral provider. 

Referred By 

The short name of the provider that has referred the patient out. 

Referral Provider 

The provider to which the patient was referred out

Location 

The short name of the Location from which the patient was referred out. 

Patient ID 

This is the system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the patient's record of referrals. 

Patient Name 

The name of the individual that was referred out. 

Phone Number 

The contact number of the individual referred out. 

Referral Date 

The date the patient was referred out. 

Last Visit 

The date of the patient's last visit to your office. 

Exp. Visit 

The date of expected visit from the patient recorded during the time of refer out. 

Next Visit 

The date of the patient's next visit to your office (if an appointment is scheduled).

Permissions


Permissions for the Refer Out report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Refer Out Report. Only users with Generate Refer Out Report permission set as Yes will be able to generate the report.


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Written by Aaqib Mohammed Sali | Last published at: August 22, 2021


Overview 


Appointment reports are intended to show both past and future trends of scheduling and opportunities for improvements. There are often production goals associated with scheduling, and appointments can be strategically placed in order to meet these goals.

The Appointments by Provider report can be used to find the count of appointments, appointment details, and production for each provider. This report shows real-time data and is available in two views- Summary and Detail view. 

The summary view shows the total count of appointments and scheduled production either by appointment location or by appointment primary provider. The users have the flexibility to view the report by the appointment primary provider or by appointment location. The detail view shows the patient level drill-down of each appointment including details like patient’s phone number, appointment date and time, operatory, appointment providers and duration, the scheduled production of the appointment, the patient estimate of scheduled production, etc.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary View

For the Appointments by Provider Summary View report, your filter options include:

Group By* 

Appointment by Provider summary view report can be grouped by appointment provider or by appointment location.

Dates* 

Appointment by Provider report is dated by appointment date. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. 

Location* 

Select a location or locations to focus the report on the appointments in the selected location(s). By default, the location will be the user’s default location.

Provider

Select a provider or providers to focus the report on appointments with the selected provider(s) as primary treatment provider. 

Prod. Type

Choose to focus the report based on the selected Production Types.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Exclude Inactive/ Duplicate Patients

Checkmark this option if you would like to exclude Inactive/Duplicate Patients from the report. By default, it will be checked.

Detail View

For the Appointments by Provider Detail View report, your filter options include:

Dates* 
Appointment by Provider report is dated by appointment date. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day.

Location* 
Select a location or locations to focus the report on the appointments in the selected location(s). By default, the location will be the user’s default location.

Appt. Type* 
Generate your report data based on the selected appointment types. You can choose to view the appointments booked by the user in the system or booked by the patient using the Online Booking feature or both.

Provider
Select a provider or providers to focus the report on appointments with the selected provider(s) as a primary treatment provider.

Appt. Mode* 
Generate your report data based on the selected appointment modes. You can choose to view the appointments that are In-Office appointments or Tele-appointments or both.

Prod. Type
Choose to focus the report based on the selected Production Types.

Patient Flag
Choose to focus the report based on the patients with the selected patient flags.

Patient
Choose to focus the report based on the selected patients.

Appt. Status
Choose to focus the report based on the selected status of the appointment.

Exclude Inactive/Duplicate Patients
Checkmark this option if you would like to exclude Inactive/Duplicate Patients from the report. By default, it will be checked.

Columns*
Choose the columns you wish to see in this report. By default, all the columns excluding carrier and schedule patient prod will be selected.

Sorting


The default sorting for Appointment by Provider report will be by Appt date (desc) and Appt time (asc). Sorting is possible on Operatory and Sched. Prod columns as well.

Results


Summary View Report

The report provides information in column form grouped by either primary appointment provider or appointment location as selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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The results columns shown in this report include:

Location

The location for which the appointment was scheduled.

Provider

The practice primary treatment provider who is a part of appointments in the selected date range.

Checked Out

The number of appointments with this provider/location combination that are in the Checked-Out status (along with the dollar amount produced by the treatment included in these appointments).

Scheduled

The number of appointments with this provider/location combination that are in the Scheduled status (along with the dollar amount produced by the treatment included in these appointments).

Cancelled

The number of appointments with this provider/location combination that are in the Cancelled status (along with the dollar amount produced by the treatment included in these appointments).

No Show

The number of appointments with this provider/location combination that are in the No show status (along with the dollar amount produced by the treatment included in these appointments).

Other

The number of appointments with this provider/location combination that are in a status other than the ones specified here (along with the dollar amount produced by the treatment included in these appointments). 

All

The total number of appointments with this provider/location combination (along with the dollar amount produced by the treatment included in these appointments).

The report also has a totals row “Grand Total” that shows the consolidated totals of number and scheduled production of appointments in each status group under each grouping selected. 

The blue colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these appointments and their details.

Detail View Report

The results columns shown in this report include:

Appt. Date 

The date for which the appointment was scheduled to take place.

Appt. Time 

The time for which the appointment was scheduled to take place.

Patient Name

The name of the patient scheduled to be seen in the appointment.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Appointments page of the patient's profile.

DOB

The patient's date of birth according to the information specified on their patient profile.

Phone No

The patient's phone number.

Location

The location for which the appointment was scheduled.

Prov. 1

The primary treatment provider of the appointment. 

Prov. 1 Time

The amount of time the primary treatment provider is projected to spend with the patient during this appointment. 

Prov. 2

The secondary treatment provider of the appointment. 

Prov. 2 Time

The amount of time the secondary treatment provider is projected to spend with the patient during this appointment. 

Prov. 3

The tertiary treatment provider of the appointment. 

Prov. 3 Time

The amount of time the tertiary treatment provider is projected to spend with the patient during this appointment. 

Carrier

The primary carrier of the patient. 

Appt. Mode

This column indicates if the appointment is an in-office or tele-appointment.

Online Appt

This column indicates whether the appointment was scheduled by the patient using the Online Booking feature.

Operatory

The operatory for which the appointment was scheduled to take place.

Prod. Type 

The type of production to be generated by this appointment.

Appt. Status

The current status of the appointment, whether it has been Confirmed, Rescheduled, Checked Out, and so on.

Sched. Patient Prod

The dollar amount scheduled to be produced by the treatment(s) that is payable by the patient included in this appointment.

Sched Prod

The dollar amount scheduled to be produced by the treatment(s) included in this appointment.

Notes 

Any notes that have been included in the appointment details.

Use Cases


Appointment reports are intended to show both past and future trends of scheduling and opportunities for improvements.

Special Cases


Permissions


Permissions for the Appointments by Provider report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Appointments by Provider Report. Only users with Generate Appointments by Provider Report permission set as Yes will be able to generate the report.

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Written by Athul V Suresh | Last published at: August 23, 2021


Overview


The Payment Reconciliation report is used to make the reconciliation of all payment receipts added to the practice. It can be used to view the receipts added in the selected locations from patient insurance and collection agency and deletion of receipts. The report shows the applied payments within the selected date range, all adjustment transactions, reversals, refunds, Adj off's, and Transfers. 

All the refunds, receipt deletions, Adj-off will be in red color inside brackets to indicate a negative transaction. The report pulls real-time data in a single view. The report is based on the transaction date of the actions performed.

The report is grouped into sections based on the actions and has a totals row for each section. The actions are receipt addition, applied payments, adjustments, provider adjustments, refunds, Adj off, and transfers. The report will give the user a drill down off transactions associated with the action, the patients, carrier, or collection agency associated with the action. The report also shows codes the payments have been applied, the DOS of the code, the treatment provider, treatment location, and so on.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

For the Payment Reconciliation report, your filter options include:

Date range*

The payment reconciliation report is based on the transaction date. Choose the date range to focus your report on the selected date range. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. 

Trans. Location*

Choose this option to focus your report on the transaction location.

Trans. User

Choose this option to focus your report on the transactions made by the selected User. If no users are selected, the default will be all users.

Action

Choose this option to focus your report on specific actions. If no actions are selected by default all actions will be selected.

Payment location

Choose this filter to focus your report on the location the receipt(s) has been added.

Receipt user

Choose this option to focus your report on users that updated the receipt.

Payment type

Choose this option to focus your report on the selected payment types.

Payment category

Choose this option to focus your report on the payment category of the receipt like cash, check, direct transfer, and so on.

Paying entity

Choose this option to focus your report on payment entities like patient, insurance, or collection agency.

Adjustment code

Choose this option to focus your report on the selected Adjustment codes.

Provider Adjustment

Choose this report to focus your report on the selected provider adjustments.

Amount*

Focus the report on transactions for an amount that is "less than" "greater than" "equal to" (and so on) than the dollar amount you specify here. By default, not equal to $0 is selected.

Columns*
Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


The default sorting in the payment reconciliation report is by transaction date. The user can also sort by amount, patient Gross production, and insurance gross production.

Results


The report provides information in column form grouped by the above-mentioned actions and has a totals row for each group. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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The result columns shown in this report include:

Trans. User

The user who made the transaction.

Patient ID

ID of the patient in context.

Patient Name

The name of the patient to which the transaction applies, whether it was a completed code, refund, deleted receipt, or so on. 

Carrier

The insurance carrier to which the payment, refund, or adjustment applies.

Collection agency

The collection agency to which the payment, refund, or adjustment applies.

Amount

The amount involved in the transaction (-ve sign for deletions, deductions and reversals). 

Trans. Location

The location in the transaction was completed. 

Trans. Date

Transaction date of the transaction.

Trans. Provider

The provider associated with the transactions like Applied Payments, Adjustments, and so on.

Adj. Code

Adjustment code associated with the adjustment transaction. The adj code applied only during adding a receipt will show up in the report.

Refund Date

Refund date associated with the refund transaction.

Prov Adj Type

Type of provider adjustment associated with Provider adjustment transaction.

Transaction charge

The transaction charge associated with payment types like care credit.

Unadjusted transaction charge

The total amount of unadjusted transaction charge.

Receipt#

The receipt ID of the receipt in context. On clicking the receipt ID the user is taken to the patient's ledger or insurance payment page depending on the payment entity of the receipt.

Paying entity

The entity against whom the receipt in context is addressed. (Patient, Insurance, Coll. Agency)

Paying entity name

The name of the entity against whom the receipt in context is addressed.

Payment category

The payment category of the receipt like cash, check, direct transfer, and so on .

Payment type

The payment type of the receipt.

Payment date

The payment date of the receipt. This is the actual date the patient paid the practice.

Receipt Add Trans. Date

The date on which the payment was recorded in CareStack.

Receipt type

This column shows whether the receipt type is Regular payment or Advance payment.

Payment Location

The location in which the receipt was added or simply the payment location of the receipt.

Receipt user

The user who added the receipt on which the transaction action was done.

Claim ID

The Claim ID of the claim that was used to post payments from the insurance receipt.

Code

The code against which the transaction was done.

DOS

The DOS of the code against which the transaction was done.

Tx. Provider

The treatment provider of the code against which the action is made.

Tx. location 

The treatment location of the code against which the action is made. 

Pat. Gross Production

The dollar value of the patient balance of the code against which the transaction was made.

Ins. Gross Production

The dollar value of the insurance balance of the code against which the transaction was made.

Special Case


The transaction location and payment location and treatment location denote where the receipt was added, where the payment was added, and where the treatment was completed. These locations may or may not be the same for all entries in the report.

Permissions


Permissions for the Payment Reconciliation Report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Payment Reconciliation Report. Only users with Generate Payment Reconciliation Report permission set as Yes will be able to generate the report.


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Written by Mathew Kandirickal | Last published at: August 27, 2021


Overview


The Income Allocation report details provider performance measured in terms of Opening Balances and Closing Balances, Production and Collection Amounts/Adjustments, as well as Outstanding Credits within the selected time frame. 

The Income Allocation Report is based on Transaction Date and shows real-time data. The report is available in five different views - Income Allocation, Net Production, Net Applied Payments, Allocated Advance Payments, and Adjustments views. 

The Income Allocation view shows the high-level grouping for all the production. It shows the Opening, Closing Balances, Gross Production, Production adjustments, Net Production, Applied payments, Collection adjustments, Net applied grouped by either location or provider. The Net Production view shows the information of how each code contributes to the production, the patient and insurance split, etc, and the patient and insurance production adjustments. The Net Applied Payments can be used to track the payment that has been applied to the code and also shows the estimate of the code. It shows the patient payments and insurance payments and collection adjustment applied to codes and also includes the reversals if any. The allocated advance payments view allows the user to see the payments which have been applied from advance receipts and shows the treatment information to which the payment is applied and receipt information of the advance receipt. The Adjustments view gives detail on the patient and insurance adjustments made between the selected date range.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria is important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t.

Income Allocation View

For the Income Allocation View, the filter options include:

Group By* 

Decide whether to group the report results by Provider or Location. By default, the Provider will be selected.

Date Range* 

Income Allocation report is dated by Transaction date. Focus the report on transactions made within your selected date range. By default, the current date will be selected.

Location* 

Focus the report on transactions completed at the selected location(s). By default, the user's default location will be selected.

Provider Type*  

Generate the report data based on the type of provider (dentists, hygienists, or both). By default, All is selected.

Provider 

Choose whether to focus the report on the selected treatment provider(s). 

Patient Flag 

Choose whether to focus the report based on patients with the selected patient flag(s).

Exclude Inactive Providers  

Checkmark this option to exclude inactive providers from the report.  

Single Group Per Page  

Checkmark this option to separate each group of generated data onto its own page (whether grouped by provider or location, each will be individualized into separate pages of the report). 

Net Production View

For the Net Production View, the filter options include:

Date Range*  

Income Allocation report is dated by Transaction date. Focus the report on transactions made within the selected date range. By default, the current date will be selected. 

Location*  

Focus the report on transactions completed at the selected location(s). By default, the user's default location will be selected. 

Provider 

Choose whether to focus the report on the selected treatment provider(s). 

Patient Flag 

Choose whether to focus the report based on patients with the selected patient flag(s)

Code 

Choose the procedure codes to be included.

Exclude Inactive Providers 

Checkmark this option to exclude production from the inactive providers in the report. 

Net Applied Payments View 

For the Net Applied Payments View, the filter options include:

Date Range*  

Income Allocation report is dated by Transaction date. Focus the report on applied payment transactions made within the selected date range. By default, the current date will be selected. 

Location*  

Focus the report on transactions completed at the selected location(s). By default, the user's default location will be selected. 

Provider 

Choose whether to focus the report on the selected treatment provider(s). 

Patient Flag 

Choose whether to focus the report based on patients with the selected patient flag(s).

Code 

Choose the procedure codes to be included.

Exclude Inactive Providers 

Checkmark this option to exclude inactive providers from the report. 

Allocated Advance Payments 

For the Allocated Advance Payments View, the filter options include:

Date Range* 

Income Allocation report is dated by Transaction date. Focus the report on transactions made within the selected date range. By default, the current date will be selected. 

Receipt Location* 

This is used to filter out applied payments and reversals that come from advance patient receipts from the selected location as the receipt location. By default, the user's default location will be selected. 

Receipt Provider 

This is used to filter out advance receipts added against a particular provider. 

Treatment Location 

This is used to filter out applied payments that are made on the selected locations. 

Treatment Provider 

This is used to filter out applied payments posted against a particular provider. 

Code 

Choose to filter out codes against which applied payments were made. 

Patient Flag 

Choose patient flags to filter out applied payments made against patients with selected flags.

Exclude Inactive Providers 

Checkmark this option to exclude inactive providers in the report

Adjustments View 

For the Adjustments View, the filter options include:

Date Range* 

Income Allocation report is dated by Transaction date. Focus the report on transactions made within the selected date range. By default, the current date will be selected. 

Location*  

Focus the report on transactions completed at the selected location(s). By default, the user's default location will be selected. 

Provider 

Choose whether to focus the report on the selected treatment provider(s). 

Patient Flag 

Choose whether to focus the report based on patients with the selected patient flag(s).

Adjustment Category 

Choose the adjustment category from Production or Collection.

Exclude Inactive Providers 

Checkmark this option to exclude inactive providers in the report

Results 


Income Allocation View

The report provides information in column form grouped by either provider or location as selected. The report also has a consolidation of the income allocation values across all the selected providers and locations at the end of the report. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.


Related image: ./carestack-questions-2023-03-02_files/1629392984820-1629392984820.png


The results columns shown in this report include:  


Provider 

The treatment provider to which these transactions apply.

Location  

The treatment location to which these procedures and transactions apply.

Opening Balance 

The opening balance of outstanding charges that remained to be collected going into this selected time period.

Gross Production 

The dollar amount of production generated from procedures completed by this provider at this location.

( + ) Production Adjustment 

The dollar amount of positive adjustments made against this provider's production generated at this location.

( - ) Production Adjustment 

The dollar amount of negative adjustments made against this provider's production generated at this location.

Net Production 

The dollar amount of production generated by this provider at this location, including any production adjustments made.

Applied Payments 

The dollar amount of payments that have been applied towards these balances.

( + ) Collection Adjustment 

The dollar amount of positive adjustments made against this provider's expected receivables at this location.

( - ) Collection Adjustment 

The dollar amount of negative adjustments made against this provider's expected receivables at this location.

Net Applied Payments 

The dollar amount of payments applied towards these balances after any collection adjustments made.

Closing Balance 

The remaining balance to be collected for this provider at this location after production generated and receivables collected during this time period.

Total UCR 

The total UCR of procedure codes checked out transactionally in the selected date range.

Gross Production 

The total dollar amount of production generated during this time period according to the procedure fees at the time of code completion.

Production Adjustments 

The total dollar amount of production adjustments completed during this time period.

Net Production 

The total dollar amount of production generated during this time period including any production adjustments made.

Migrated Production 

The total production brought in by the MSB codes.

Advance Payments 

The total dollar amount of advance payments collected during this time period.

Allocated Advance Payments 

The total dollar amount allocated from the advance receipts added in the selected date range.

Applied Payments 

The total dollar amount of payments applied against the outstanding balances during this time period.

Collection Adjustments 

The total dollar amount of collection adjustments made against patient and insurance receivables during this time period.

Net Applied Payments 

The total dollar amount of payments applied during this time period after any collection adjustments made.

Income Reduction 

The total dollar amount of income reduction payment type added against the provider

Net Production View 

The net production view lists out all the procedure codes completed and the production adjustments made in the selected date range. This view has three sections- the first section shows the completed procedure codes completed with a totals column that shows the consolidated UCR, Contractual adjustment, Pat amount, Ins amount, and Production. The second section shows the patient adjustments and the third section shows the insurance adjustments. Both these sections also have a totals column showing the total patient and insurance adjustments made. The end of the report shows the Grand Total- Gross production, Grand Total- Production adjustments, and Grand Total- Net production.

Related image: ./carestack-questions-2023-03-02_files/1629393111101-1629393111101.png

The results columns shown in this report include: 

Transaction Date 

The date the transaction was completed in the system. 

Patient Name 

The name of the patient that was seen for treatment. 

Code Description 

The procedure code that was completed for this patient, along with its description. 

D.O.S 

The date on which the patient was seen by their treatment provider for the completion of these services.

UCR 

The office's standard fee for this procedure code according to the practice settings.

Contractual Adjustment  

The contractual adjustment made to the payable according to the difference between the office's standard fee for this procedure and what the insurance carrier has agreed to pay. 

Patient Amount  

The expected patient receivable. 

Insurance Amount  

The expected insurance receivable. 

Production  

The dollar amount of production generated from completing this treatment.

Adj.Code - Desc.(Action)  

The adjustment code used to adjust the resulting balance for treatment completed (along with the description and action of the adjustment code).

User's Name  

The user that completed the transaction in the system.

Carrier

The name of the insurance carrier for which an adjustment was made.

Net Applied Payments View 

The net applied payment view consists of patient payments that are applied, insurance payments that are applied grouped by each carrier, the reversals of payments applied, collection patient adjustments, and collection insurance adjustments. Each of these sections and groupings has the totals shown and shows the consolidated  Grand Total - Applied Payments, Grand Total - Reversals, Grand Total - Collection Adjustments, Grand Total - Net. Applied Payment at the end of the report.

Related image: ./carestack-questions-2023-03-02_files/1629394452448-1629394452448.png The results columns shown in this report include:

Transaction Date 

The date the transaction was completed in the system.

Patient Name 

The name of the patient that was seen for treatment.

Code - Description 

The procedure code that was completed for this patient, along with its description.

D.O.S. 

The date on which the patient was seen by their treatment provider for the completion of these services.

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system.

User's Name 

The user that completed the transaction in the system.

Patient Balance 

The patient balance at the time of checkout.

Applied Payment 

The dollar amount that has been paid towards this balance.

Plan 

The plan which is associated with the patient.

Claim ID 

The identifier of the claim or claim number.

Ins Amount 

The expected insurance receivable. 

Carrier/Collection Agency 

The carrier or collection agency in the context.

Adj Code Desc 

The adjustment code used to adjust the resulting balance for treatment completed (along with the description and action of the adjustment code). 

Allocated Advance Payments View

The allocated advance payments view shows the payments that are applied from the advance receipts from the selected locations in the selected date range. The applied payments allocated from the advance receipts are shown as positive, while its reversals appear negative. This differs from the primary report. The view also has a total that shows the total applied payments that are allocated from the advance receipts which were added in the selected date range.

Related image: ./carestack-questions-2023-03-02_files/1629395422812-1629395422812.png

The results columns shown in this report include:

Transaction Date 

The date the transaction was completed in the system. 

Patient Id 

The Identifier of the patient that was seen for treatment. 

Patient Name 

The name of the patient that was seen for treatment.

Receipt Location 

The receipt location of the advance receipt in context.

Receipt Provider 

The receipt provider of the advance receipt in context. 

Treatment Location 

Treatment location of the code.

Treatment Provider 

Treatment provider of the code.

Applied Payment 

The amount applied against the code from the advance receipt.

Paying Patient 

Mentions the name of the patient who is paying the amount.

Code 

Mentions the treatment procedure in context.

Code Desc 

The procedure code completed for this patient, along with its description. 

Date of Service 

The date on which the patient was seen by their treatment provider for the completion of these services. 

Patient Amount 

The expected patient receivable. 

Insurance Amount 

The expected insurance receivable. 

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system. 

User's Name 

The user that completed the transaction in the system. 

Adjustments View

The adjustments view consists of two sections- patient side production/ collection (as selected) adjustments and insurance production/ collection (as selected) adjustments. Each of these sections and has the totals shown and shows the consolidated  Grand Total - Production/ Collection (as selected) Adjustments at the end of the report.

Related image: ./carestack-questions-2023-03-02_files/1629394951220-1629394951220.png

The results columns shown in this report include:

Transaction Date 

The date the transaction was completed in the system.

Patient Name 

The name of the patient that was seen for treatment.

Code 

The procedure code completed for this patient, against which an adjustment was made. 

D.O.S. 

The date on which the patient was seen by their treatment provider for the completion of these services. 

Adj. Code - Desc. (Action) 

The adjustment code used to adjust the resulting balance for treatment completed (along with the description and action of the adjustment code). 

User's Name 

The user that completed the transaction in the system.

Amount  

The dollar amount of the adjustment completed.  

Carrier  

The name of the insurance carrier for which an adjustment was made.

Permissions


Permissions for the Income Allocation report will be in System Menu -> Practice Settings -> Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Income Allocation Report. Only users with Generate Income Allocation Report permission set as Yes will be able to generate the report.

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Written by Roshni R | Last published at: August 23, 2021


Overview


This report is intended to be used daily as a measurement of what is being allowed to walk out the door with respect to patient financial responsibility. This report can be used to see how much the patient owes the practice at the end of day.


This report shows real-time data and has two views- summary view and detail view. The summary view shows the total starting balance and ending balance for each selected location by transaction date. Transaction date is the date on which the user entered the transaction in the system. It may or may not be different from the actual DOS/payment date. The detail view shows the walkout details of each patient who was seen on the selected date range and includes details like their unapplied credits, total patient responsibility, etc.


Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary View

For the walkout balance Summary View report, your filter options include:

Date Range*

Walkout Balance report is dated by Transaction date. Focus your report based on balances created in the specific date range. Select a maximum of up to 1 year.

Location*

Select location(s) to focus your report based on balances created in the selected Locations.

Detail View

For the walkout balance Detail View report, your filter options include:

Date Range*

Walkout Balance report is dated by Transaction date. Focus your report based on balances created in the specific date range. Select a maximum of up to 1 year. 

Location*

Select location(s) to focus your report based on balances created in the selected Locations. 

Patient flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Columns*

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


The default sorting for the Walkout Balance report will be by Trans date (asc). Sorting is possible on Total Patient Resp, Starting Balance, Ending Balance, Unapplied Credits, Last paid amount, and last paid date columns as well.

Results


Summary View Report

The report provides information in column form for each date of transaction and the starting balance for the day and ending balance for the day. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.


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The results columns shown in this report include:

Trans. date

The date on which the patient's treatment was marked as complete in the system. It may or may not be the same as the DOS of the treatment.

Starting balance

The balance the patient has on their account after the completion of their treatment. It is the fees of code minus any adjustments made and payments applied on the same date for the code.

Ending Balance

The outstanding amount from the balance the patient walked out with. It is fees for the code minus any patient payment applied to the balance.

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing each patient that walked out with or without a balance.

Detail View Report

Related image: ./carestack-questions-2023-03-02_files/1629412164712-1629412164712.png

The results columns shown in this report include:

Patient Name

The name of the patient who has a starting balance due to treatment(s) completed within the selected time frame.

Patient ID

This is the system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to this patient's ledger.

Trans Date

The date on which the patient's treatment was marked as complete in the system.

Location

The location in which the patient's treatment was completed.

Total Patient Resp

The total patient payable for services completed on this date. 

Starting balance

The balance the patient has on their account after the completion of their treatment. It is the fees of code minus any adjustments and payments applied on the same date for the code.

Ending Balance

The outstanding amount from the balance the patient walked out with. It is fees for the code minus any patient payment applied to the balance.

Unapplied Credits

The monetary credits the patient has available on their account if any. 

Last Paid Amount

The last dollar amount the patient has paid to your office. 

Last Paid Date

The last date a payment was made by the patient.

Last Paid To

The user who entered the receipt for the last payment that was made by the patient. 

Permissions


Permissions for the Walkout Balance report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Walkout Balance Report. Only users with Walkout Balance Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629412889859-1629412889859.png



Written by Roshni R | Last published at: August 23, 2021


Overview


The pending eligibility/verification report is intended to view patients with upcoming appointments whose insurance plan or eligibility needs to be verified. The report can be used to review upcoming appointments with patients’ insurance either in draft or eligibility pending status. 

This report shows real-time data. The report shows separate entries for primary, secondary, and tertiary insurances that the patient has.

The data captured is according to the date range specified. Only the appointments between the date that has insurance either in draft or eligibility pending status will be displayed. It will also show insurances that did not have had their insurance eligibility last completed before the specified number of days. There is only a single view for this report but it includes all the necessary information. 

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Date Range*

The pending eligibility report is dated by appointment date. Select the date range to focus your report on patients with an upcoming appointment that falls within the selected date range, and have had their insurance eligibility last completed before the number of days specified in the Days Since Last Eligibility filter. The date range can be selected for a maximum of 3 months. The default date range is 2 days from the date of generation. 


Location*

Select the location(s) to focus your report on patients with the selected appointment location(s). The default location will be the default location of the user. 


Provider

Select provider(s) to focus your report based on patients with the selected primary appointment provider(s).


Insurance Status*

Select insurance status to focus your report on patient insurance that is either pending verification, pending eligibility, or choose to include all. By default, All will be selected.


Insurance Type*

Select insurance type to focus your report only on dental insurance, medical insurance, or choose to include both. By default, All will be selected.


Carrier

Select carrier to focus your report only on the selected carrier(s).


Insurance Hierarchy

Select Insurance Hierarchy to focus your report only on primary dental insurances, primary medical insurances, secondary dental insurances, or so on. 


Patient Flag

Select patient flags to focus the report based on the patients with the selected patient flags.


Patient

Select patient to focus the report based on the selected patients.


Days Since Last Eligibility

Choose whether to focus your report on patients with an insurance plan that last had eligibility completed within the last 30 days, 31-60 days, 61-90 days, 90+ days, or select Days Greater Than to specify a custom number of days.


Days Greater Than*

Generate your report based on insurance plans that have been pending eligibility or verification for a number of days greater than the number specified here. This filter is available only when the Days Greater Than is selected in the Days Since Last Eligibility filter.


Exclude Draft Insurances

Checkmark this option if you would like to exclude drafted insurance plans that have yet been added and verified.


Columns* 

Choose the columns you wish to see in this report. By default, all the columns excluding appt notes will be selected. 


Sorting


The default sorting in the Pending eligibility/verification report will be by Appt date (desc) and Appt time (asc). Sorting is also possible on the last eligibility done on column.

Results


Related image: ./carestack-questions-2023-03-02_files/1629414120940-1629414120940.png

The results columns shown in this report include:

Patient Name 

The patient who has an appointment on the specified date.

Patient ID 

The system-assigned number used to identify this patient and their records. Click on this hyperlink to be taken to this patient's insurance page.

Patient D.O.B 

The patient's date of birth according to the information included in their patient profile. 

Subscriber Name 

The name of the subscriber listed on this patient's insurance plan. 

Subscriber ID / SSN 

The subscriber's ID or social security number is used to identify the subscriber and their coverage. 

Subscriber D.O.B 

The subscriber's date of birth is used to identify the subscriber and their coverage. 

Appointment Date 

The date of the patient's next appointment. 

Appointment Time 

The time of day in which the patient's next appointment is scheduled. 

Appt Notes 

Any notes that have been included in the appointment details.

Location 

The location in which the patient's next appointment is scheduled.

Location Tax ID 

The tax ID of the location in which the patient's next appointment is scheduled. 

Scheduled Provider 

The Primary appointment provider pertaining to the patient's next scheduled appointment.

Scheduled Provider NPI 

The HIPAA-assigned National Provider Identifier number pertaining to the primary treatment provider of the patient's scheduled appointment. 

Default Provider 

The patient's default treatment provider. 

Default Provider NPI 

The unique National Provider Identifier (NPI) of the patient's default treatment provider. 

Carrier 

The carrier pertaining to this patient's insurance plan. 

Carrier Phone No 

The phone number used to reach the insurance carrier (as entered in insurance details in your practice settings). 

Carrier Website 

The website used to reach the insurance carrier (as entered in insurance details in your practice settings). 

Insurance Type 

The type of insurance coverage, whether it is dental or medical. 

Plan Name 

The name of the patient's insurance plan as it is entered in your practice settings. 

Plan Type 

The type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on. 

Group # 

The group number of this patient's insurance plan. 

Hierarchy 

The hierarchy of this patient's insurance plan, whether it is their primary dental insurance, primary medical, secondary dental, and so on. 

Status 

The current status of this patient's insurance plan, whether it is pending verification or pending eligibility. 

Last Verified On 

The date on which the insurance plan was verified. 

Last Verified By 

The user who last verified this insurance plan. 

Last Eligibility Done On 

The date on which eligibility was last completed for this patient's insurance plan. 

Last Eligibility Done By 

By The user who last completed eligibility for this patient's plan.

Use Cases


This report is used to view patients with an upcoming appointment whose insurance plan or eligibility needs to be verified. The practice can use the report to distinguish the patient’s eligibility in draft and eligibility pending status.


The practice can get an idea of all patients they need to verify the insurance before their next appointment. This will help the practice to streamline their workflow and be ready to bill the insurance and patient accordingly instead of completing treatment and hoping the insurance will pay for the code.


Special Cases


  1. If Patients have insurance with an effective date in the future then those insurances will still have an entry in the report.
  2. Patients with inactive insurances also will have entries in the report.
  3. Patients with Terminated insurance will not have an entry in the report.

Permissions


Permissions for the Pending eligibility/verification report will be in System Menu ->Practice Settings ->Administration -> Profiles ->Manage Permissions ->Insights ->Under Operational Reports ->Generate Pending eligibility/ verification Report. Only users with Generate Pending eligibility/ verification permission set as Yes will be able to generate the report.


Related image: ./carestack-questions-2023-03-02_files/1629414565034-1629414565034.png



Written by Roshni R | Last published at: August 22, 2021


Overview


This report is used to track user time clock data and provides time-based pay details. The Clock In/ Clock Out report can be used to find the total number of hours the user clocked in and the payment details based on those hours. This report shows real-time data.

The Clock In/ Clock Out report shows the clock in/ clock out date and time, the total hours the user clocked in, the pay rate per hour for normal hours and for overtime hours, the pay for normal and overtime pay, and gross pay for the user.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Dates* 

Clock In/ Clock Out report is dated by action date. You can generate your report data based on time clock actions completed within the selected date range. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. 

Location* 

Select a location or locations to focus the report based on time clock actions for the selected location(s). By default, the location will be the logged in user’s default location.

User*

Select a user(s) to focus the report on time clock data based on the selected user(s). 

Sorting


The default sorting for Clock In/ Clock Out report will be by Date (asc) and Clock In time (asc). 

Results


The report provides information in column form grouped by each user selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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The results columns shown in this report include:

Date

The date pertaining to the day the user has clocked in or out.

Clock IN

The time of day the user was clocked in. 

Clock OUT

The time of day the user was clocked out. 

Location

The location at which the user was clocked in or out.

Total Hours

The calculated number of hours the user was clocked in before later clocking out.

Normal Pay Rate/ Hr

The Normal Pay Rate for this user per hour (as specified in their User Setup). Click this hyperlink to be taken to this user's setup.

Normal Pay

The calculated dollar amount of Normal Pay for this time entry (according to the specified Normal Pay Rate and Total Hours clocked-in for this time entry). 

Overtime Pay Rate/ Hr

The Overtime Pay Rate for this user per hour (as specified in their User Setup). Click this hyperlink to be taken to this user's setup.

Overtime Pay

The calculated dollar amount of Overtime Pay for this time entry (according to the specified Overtime Pay Rate and Total Overtime Hours clocked for this time entry).  

Gross Pay

The gross dollar amount of pay calculated for this time entry including Normal Pay and Overtime Pay.  

Notes

The notes if added when the time clock entry was added or edited would be shown here.

Totals    

The Totals are provided for the total number of hours worked and the total calculated dollar amount of Normal Pay, Overtime Pay, and Gross Pay (respectively) for all time entries this user-generated within the specified date range. 

Use Cases


The Clock In/ Clock Out reports are used to track user time clock data and provide time-based pay details. This report can be used to find 

Special Cases


  1. The report will list all clock in or out entries even if the clock in or clock out time was not entered. If any of the clock in or clock out time or both is missing, the total hours will be 0.
  2. If the Normal Pay rate or Overtime Pay rate is edited in User Setup, the edited values will be used for dates after the edit. For the previous dates, the previous values of rates would be used for the calculations.

Permissions


Permissions for the Clock In/Clock Out report will be in System Menu ->Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Clock In/Clock Out Report. Only users with Generate Clock In/Clock Out Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629415494456-1629415494456.png



Written by Roshni R | Last published at: August 23, 2021


Overview


The Lab Case report shows all the lab cases that are linked to an appointment. This report is used to identify the patients that have pending lab cases, allowing you to track cases that are due or overdue. This report shows real-time data.

The Lab Case report shows the patient details, the appointment details of the linked appointment, the sent date, due date, received date, and lab cost. The user has the flexibility to group the lab cases by lab, location, or provider. The total number of lab cases and the total cost of all the lab cases under each individual group will also be shown in the report.


Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

For the Lab Case report, your filter options include:

Date As* 

Choose whether to run this report by the following options :

Date Range*  

Choose a date range to focus the report on lab cases with an appointment date falling within the selected date range, or lab cases that have been created/ sent/ due/ received within the selected date range. The date range can be selected for a maximum of up to 1 year. By default, the date range will be for the current day. 

Provider

Select a provider or providers to focus the report on lab cases associated with the selected providers.

Location* 

Select a location or locations to focus the report on lab cases associated with appointments in the selected appointment location(s). By default, the user’s default location will be selected. 

Lab

Choose to focus the report on lab cases associated with the selected lab(s) .

Group By

Choose whether to group the report results by Labs, Location or Provider.

Include Notes

Choose whether to include the lab notes in the report.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Sorting


The default sorting for the Lab Case report will be by Appt date (desc) and Appt time (asc). Sorting is possible on Created Date, Lab Cost, Due Date, and Received Date columns as well.

Results


The report provides information in column form grouped by Lab or Location or Provider as selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1629417827790-1629417827790.png

The results columns shown in this report include:

Patient Name

The name of the patient scheduled to be seen in the appointment.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Appointments page of the patient's profile.

Created Date

The date on which the lab case was created in the system.

Appt. Date

The date of the patient’s appointment associated with this lab case.

Appt. Time

The time for which the associated appointment is/was scheduled.

Lab

The dental lab to which the lab case was sent.

Location

The location of the associated appointment.

Provider

The treatment provider of the Lab case. 

Prod. Type

The type of production to be generated from the associated appointment.

Lab Cost

The estimated or actual cost of this lab case.

Tooth #

The tooth numbers if any associated with the lab case.

Tooth Shade

The tooth shade associated with the lab case.

Appt. Status

The current status of the patient’s appointment associated with this lab case.Sent Date: The date the lab case was sent to the dental lab.

Due Date

The date the lab case was projected to be due.

Received Date

The date the lab case was received back.

Reference No.

The reference number of the lab case.

Notes

Any notes that have been included in the lab case.

Use Cases


The Lab Case report is used to identify the patients that have pending lab cases, allowing you to track cases that are due or overdue. You can use the Lab Case report,

To track the lab cases that were created on the date range 

To track the total lab cases and lab cost against 

Special Cases


  1. The report shows lab cases that are linked with an appointment. If no appointment is linked with a lab case, this lab case won't show up on the report.

Permissions


Permissions for the Lab Case report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions ->Insights ->Under Operational Reports ->Generate Lab Report. Only users with Generate Lab Report permission set as Yes will be able to generate the report.

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Written by Abhishek Vijay | Last published at: August 22, 2021


Overview


Appointment reports are intended to show both past and future trends of scheduling and opportunities for improvements. There are often production goals associated with scheduling, and appointments can be strategically placed in order to meet these goals.

The Appointments by User report can be used to find the count of appointments, appointment details, and production for appointments that were created by each user. This report shows real-time data and is available in two views - Summary and Detail view. 

The summary view shows the total count of appointments that were created, scheduled production, and average scheduled production either by appointment location or by user who created the appointment. The users have the flexibility to view the report by the user who created the appointment or by appointment location. 

The detail view shows the patient level drill-down of each appointment including details like scheduled date, patient’s phone number, appointment date and time, operatory, appointment providers and duration, the scheduled production of the appointment, the patient estimate of scheduled production, etc.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary View

For the Appointments by User Summary View report, your filter options include:

Group By* 

Appointment by User summary view report can be grouped by user that created the appointment or by appointment location. 

Dates* 

Appointment by User report is dated by scheduled date (appointment creation date).  The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. 

User*

Select a user(s) to focus the report on appointments that were created by the selected user(s).

Location

Select a location or locations to focus the report on the appointments in the selected location(s). By default, the location will be the user’s default location.

Prod. Type

Choose to focus the report based on the selected Production Types.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Exclude Inactive/Duplicate Patients

Checkmark this option if you would like to exclude Inactive/Duplicate Patients from the report.  By default, it will be checked.

Detail View

For the Appointments by User Detail View report, your filter options include:

Dates* 

The appointment by User report is dated by scheduled date (appointment creation date).  The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day.

Appt. Type* 

Generate your report data based on the selected appointment types. You can choose to view the appointments booked by the user in the system or booked by the patient using the Online Booking feature or both.

User*

Select a user(s) to focus the report on appointments that were created by the selected user(s). 

Location

Select a location or locations to focus the report on the appointments in the selected location(s). By default, the location will be the user’s default location.

Appt. Mode* 

Generate your report data based on the selected appointment modes. You can choose to view the appointments that are In-Office appointments or Tele-appointments or both.

Prod. Type

Choose to focus the report based on the selected Production Types.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Appt. Status

Choose to focus the report based on the selected status of appointment.

Exclude Inactive/Duplicate Patients

Checkmark this option if you would like to exclude Inactive/Duplicate Patients from the report.  By default, it will be checked.

Columns*

Choose the columns you wish to see in this report. By default, all the columns excluding carrier and sched patient prod will be selected.

Sorting


The default sorting for Appointment by User report will be by Appt date (desc) and Appt time (asc). Sorting is possible on Operatory and Sched. Prod and Sched. Date columns as well.

Results


Summary View Report

The report provides information in column form grouped by either the user that created the appointment or the appointment location as selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1629458402225-1629458402225.png
The results columns shown in this report include:

Location

The location at which the appointment was scheduled.

User Name

The user that created the appointment in the system.

Appt Count

The number of appointments this user has scheduled for this location during the selected time frame.

Sched. Production

The dollar amount scheduled to be produced by the treatment included in this appointment. 

Avg. Sched. Production

The average dollar amount scheduled to be produced by these appointments. This is calculated by dividing the amount of scheduled production by the number of appointments scheduled.

The report also has a totals row “Grand Total'' that shows the consolidated totals of number, scheduled production, and avg scheduled production of appointments for each grouping (user/ location) selected. 

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these appointments and their details.

Detail View Report

Related image: ./carestack-questions-2023-03-02_files/1629458402408-1629458402408.png
The results columns shown in this report include:

User’s Name

The user that created the appointment in the system.

Sched. Date

The date the appointment was created in the system.

Appt. Date

The date on which the appointment was scheduled to take place.

Appt. Time

The time for which the appointment was scheduled to take place.

Patient Name

The name of the patient scheduled to be seen in the appointment.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Appointments page of the patient's profile.

DOB

The patient's date of birth according to the information specified on their patient profile.

Phone No

The patient's phone number.

Location

The location for which the appointment was scheduled.

Prov. 1

The primary treatment provider of the appointment. 

Prov. 1 Time

The amount of time the primary treatment provider is projected to spend with the patient during this appointment. 

Prov. 2

The secondary treatment provider of the appointment. 

Prov. 2 Time

The amount of time the secondary treatment provider is projected to spend with the patient during this appointment. 

Prov. 3

The tertiary treatment provider of the appointment. 

Prov. 3 Time

The amount of time the tertiary treatment provider is projected to spend with the patient during this appointment. 

Carrier

The primary carrier of the patient. 

Appt. Mode

This column indicates if the appointment is an in-office or tele-appointment.

Online Appt

This column indicates whether the appointment was scheduled by the patient using the Online Booking feature.

Operatory

The operatory for which the appointment was scheduled to take place.

Prod. Type

The type of production to be generated by this appointment.

Appt. Status

The current status of the appointment, whether it has been Confirmed, Rescheduled, Checked Out, and so on.

Sched. Patient Prod

The dollar amount scheduled to be produced by the treatment(s) that is payable by the patient included in this appointment.

Sched Prod

The dollar amount scheduled to be produced by the treatment(s) included in this appointment.

Notes

Any notes that have been included in the appointment details.

Use Cases


Appointment reports are intended to show both past and future trends of scheduling and opportunities for improvements.

Special Cases


  1. The report will list all appointments that were created. This means appointments in the Cancelled or No show status will also be counted as an appointment against that user.

  2. Once a cancelled or No show appointment is rescheduled, that appointment will still be counted against the user but the appointment status will be rescheduled and the rescheduled appointment will be shown as another appointment entry against the user who rescheduled the appointment.

  3. Deleted appointments will not be shown in the appointments by user report.

Permissions


Permissions for the Appointments by User report will be in System Menu ->Practice Settings ->Administration ->Profiles ->Manage Permissions ->Insights ->Under Operational Reports ->Generate Appointments by User Report. Only users with Generate Appointments by User Report permission set as Yes will be able to generate the report.


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Written by Abhishek Vijay | Last published at: August 22, 2021


Overview


Adjustment report is used to verify whether debit and credit adjustments have been posted correctly against the relevant procedure code balances. Adjustment reports are also used to identify trends of common adjustments so processes can be implemented to avoid them in the future. 

The Adjustments report is based on Transaction Date and shows real-time data. The Adjustment report is available in two views- Summary and Detail view. 

The summary view shows the total count and amount of the production adjustments and the collection adjustments made in each location and how each specific production/collection adjustment code has contributed to the adjustment as well. This view also shows the total count and amount of adjustment made against insurance adjustments and patient adjustments. The detail view gives detailed information on each adjustment made including details like patient name, adjustment type, adjustment code, action, etc.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria is important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t.

Summary View

For the Adjustment Summary View Report, your filter options include:

Date Range*

Adjustments report is dated by transaction date. The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day.

Location* 

Select a location or locations to focus the report on the treatment location of the procedure codes (to which the adjustments have been made against) . By default, the location will be the user’s default location.

Provider

Choose a provider or providers to focus the report on adjustments made against treatment completed by the selected provider(s). 

Adjustment Type*

Select the Adjustment type to focus the report on collection adjustments, production adjustments, or both. By default, All will be selected.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Adj.Amt*

Specify whether to generate data based on Adjustment codes with a total adjustment amount of "less than", "greater than", "equal to" (and so on) than the specified dollar amount (including both patient and insurance amounts). By default, not equal to $0 will be selected.

Detail View

For the Adjustment Detail View Report, your filter options include:

Date Range*

Adjustments report is dated by transaction date. The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day.

Location* 

Select a location or locations to focus the report on the treatment location of the procedure codes (to which the adjustments have been made against). By default, the location will be the user’s default location.

Provider

Choose a provider or providers to focus the report on adjustments made against treatment completed by the selected provider(s). 

Adjustment Against*

Select the Adjustment Against to focus the report on adjustments made against patient balances, insurance balances, or both. By default, All will be selected.

Adjustment Type*

Select the Adjustment type to focus the report on collection adjustments, production adjustments, or both. By default, All will be selected

Adjustment Code

Choose to focus your report on the selected adjustment code(s).

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

User

Choose to focus your report on adjustments made by the selected user(s). By default, the current user will be selected.

Adj.Amt*

Specify whether to generate data based on Adjustment codes with a total adjustment amount of "less than", "greater than", "equal to" (and so on) than the specified dollar amount (including both patient and insurance amounts). By default, not equal to $0 is selected.

Columns*

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


Sorting is possible on Trans. Date, D.O.S, Location, Adj.Code, Action, and User Name columns.

Results


Summary View Report

The report provides information in column form grouped by treatment location as selected. It shows the consolidated values of all locations on top as well. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1629460502433-1629460502433.png

The results columns shown in this report include:

Adjustment Type

The type of adjustment made, whether it was a collection adjustment or production adjustment.

Adjustment Code

The adjustment code used to adjust the resulting balance for treatment completed. These codes are defined by the practice and set up in your Practice Settings.

Description

The description of the adjustment code used to adjust the balance.

Insurance Adjustments

The adjustments made against insurance balances. (This includes the number of the adjustments made and the total dollar amount of these adjustments made against an insurance balance within the selected date range.)

Patient Adjustments

The adjustments made against patient balances. (This includes the number of the adjustments made and the total dollar amount of these adjustments made against a patient balance within the selected date range.)

Grand Total

The total number of the adjustments made and the total dollar amount of the adjustments made against both patient and insurance balances within the selected date range.

The report also has a totals row “Location Total” that shows the total counts of insurance and patient adjustments for this location, along with the total dollar amount of insurance and patient adjustments for this location. 

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these adjustments and their details.

Detail View Report

Related image: ./carestack-questions-2023-03-02_files/1629461527952-1629461527952.png

The results columns shown in this report include:

Adjustment Type

The type of adjustment made, whether it was a collection adjustment or production adjustment

Adjustment Against

Denotes whether the adjustment was against a patient balance or an insurance balance.

Transaction Date

The date the adjustment was made in the system.

Patient Name

The name of the patient that was seen for treatment (in which an adjustment was made against the resulting balance). 

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to this patient's ledger. 

D.O.S

The date on which the patient was seen by their treatment provider for the completion of the services against which the adjustment was made. 

Carrier

The carrier of the patient's insurance plan for which the adjustment was made (if applicable). 

Code

The procedure code in which the adjustment was made against its balance.

Provider

The short name identifying the patient's treatment provider. 

Location

The location where the treatment was completed. 

Adj Code

The adjustment code used to adjust the resulting balance for treatment completed. 

Description

The description of the adjustment code used to adjust the balance. 

Action

The action of the adjustment code used to adjust the balance (whether it was to deduct a portion of the balance, transfer the balance to the patient, and so on).

Amount

The dollar amount that was adjusted in this transaction. The amount of any adjustment made will be shown within brackets in red color and the amount of any adjustment that has been reversed will be shown in black color.

User's Name

The user that completed the adjustment in the system. 

Remarks

Any remarks the user left regarding the transaction (if applicable).

Permissions


Permissions for the Adjustments report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Adjustments Report. Only users with Generate Adjustments Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629461659823-1629461659823.png


Written by Roshni R | Last published at: August 23, 2021


Overview


This report is used to track the referral sources, as well as the production generated and receivables collected from patients that were created or had their first date of service in the selected time frame.

This report shows real time data and is available in two views- Summary and Detail view. 

Users could group the results based on Location, Referral source or Referral Category to see the referred patients.

Criteria


N.B. The filters with red asterisk signs are mandatory fields

Setting the filter criteria is important for building your report. It allows you to focus exactly on the information you need without having to wade through the information you don’t. 

Summary View

For the Refer In report, your filter options include:

Group By* 

The Summary View of the Refer In Report can be grouped by Location (Treatment Location for First DOS logic/Default Location for Created Date logic), Referral Category, and Referral source.

Date Criteria* 

Users could choose to see referred patients based on the date of their first completed service, First DOS, or by the date in which these patient records were created in the system.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the Date Criteria selection.

Referral Category

The referral sources are grouped into categories as Internal Provider(lists the practice providers), External Provider(lists the referral providers added in the system), Patient and Other Referral Sources(groups all the custom referral sources).

Location* 

Based on the date criteria selection the filter lists the patient’s first treatment location/default location. Up to 5 locations could be selected for onscreen report generation.

Practice Provider

This lists the internal practice providers and shows results based on the patients referred by each practice provider in the selected time range.

Specialty

This filter helps to filter out internal providers based on specialty.

Referral Provider

This lists the external referral providers and shows results based on the patients referred by each external provider in the selected time range.

Referral Patient

This lists the patients in the system and shows results based on the patients that referred in these new patients into the practice.

Other Referral Sources

This lists all the custom-added referral sources in the system.

Referred Patient Flag

This helps to filter out referred patients based on the selected patient flags.

Detail View

For the Refer In Detail View report, your filter options include:

Date Criteria* 

Users could choose to see referred patients based on the date of their first completed service, First DOS, or by the date in which these patient records were created in the system.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the Date Criteria selection.

Referral Category

The referral category of the referred-in patient; whether they were referred by an internal or external provider, another patient, or some other referral source.

Location* 

Based on the date criteria selection the filter lists the patient’s first treatment location/default location. Up to 5 locations could be selected for onscreen report generation.

Practice Provider

This lists the internal practice providers and shows results based on the patients referred by each practice provider in the selected time range.

Specialty

This filter helps to filter out internal providers based on specialty.

Referral Provider

This lists the external referral providers and shows results based on the patients referred by each external provider in the selected time range.

Referral Patient

This lists the patients in the system and shows results based on the patients that referred in these new patients into the practice.

Other Referral Sources

This lists all the custom-added referral sources in the system.

Referred Patient Flag

This helps to filter out referred patients based on the selected patient flags.

Columns* 

This helps users to choose the relevant columns to be listed in the detailed view. Users could now select the necessary columns and print the report as per the need.

Sorting


The default sorting for Refer In report will be by Date of Service (Asc) for past date and Appt date (asc) for future dates. Created Date, FIrst DOS, Last Visit, Gross Production (DOS).

Results


Summary View Report

The report provides information that could be pivoted based on Location, Referral Category and Referral Source.

Related image: ./carestack-questions-2023-03-02_files/1629468275606-1629468275606.png

Related image: ./carestack-questions-2023-03-02_files/1629468765571-1629468765571.png


The results appear based on the pivots and the order of pivots selected.

In the image, the pivot is by Location first, followed by referral category and then referral source.

The result columns shown in this report include:

Location

In the First DOS mode, this shows the treatment location in which the referred patient had the first DOS. In the Created date mode, it shows the default location of the patient.

Referral Category

The referral sources are grouped into categories as Internal Provider(lists the practice providers), External Provider(lists the referral providers added in the system), Patient and Other Referral Sources(groups all the custom referral sources).

Referral Source

It shows the referral source that referred the patient.

Address

This shows the address of the referred patient.

Email

This shows the email id of the referred patient.

Phone

This shows the phone number of the referred patient.

Mobile

This shows the mobile number of the referred patient.

Specialty

It shows the specialty of the internal provider who referred the patient.

Patients

t shows the count of referred patients having the same location, referral source, or referral category. On clicking this field the users are navigated to a detailed list of referred patients belonging to that pivot group.

Gross Production(DOS)

This shows the total lifetime production made by the patient.

Prod/Pat

This represents the average production made based on the referred patient pivot group.

Detail View Report
Related image: ./carestack-questions-2023-03-02_files/1629468916253-1629468916253.pngThe result columns shown in this report include:

Patient ID

The system-assigned number used to identify this patient and their records. On clicking the ID, the user is navigated to the patient’s overview page.

Patient Name

The name of the referred patient who had the first DOS or created date in the selected time range.

Created Date

The date on which the patient record was created in the system.

First DOS

The date on which the patient completed the first DOS.

Last DOS

The date on which the patient completed their last DOS as of the current day.

Gross Production(DOS)

The total lifetime production made by the referred patient to the practice.

Location

For First DOS logic this represents the treatment location of the first visit and for created date logic, it represents the default location of the patient. 

Referral Category

The referral sources are grouped into categories as Internal Provider(lists the practice providers), External Provider(lists the referral providers added in the system), Patient and Other Referral Sources(groups all the custom referral sources).

Referral Source

It shows the referral source that referred the patient.

Phone No

The patient's phone number.

Email

This shows the email id of the referred patient.

Address

The address of the new patient in context.

Use Cases


This report helps to find the following details of every new patient: 

Permissions


Permissions for the Refer In report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Refer In Report. Only users with Generate Refer In Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629469066878-1629469066878.png



Written by Abhishek Vijay | Last published at: August 23, 2021


Overview


The new patient report provides insights about the new patients that visit the practice or are scheduled to visit the practice, with a future appointment on their schedule. For past dates, users could group the report based on provider and location to get a list of patients and the production contributed by these new patients that visited each provider/location. For future days, users could check the new patients and their scheduled production for an upcoming appointment, thereby allowing practices to keep track of the prospective new patients that are incoming.

This report shows real time data and is available in two views - Summary and Detail view.

New Patient Code Configuration

Practices could configure codes that they would complete during any new patient’s visit as new patient codes through a service request. The 2 modes include:

  1. any code logic- This means a new patient visit is marked/identified by the patient completing any code, as the very first code completion in the account.
  2. specific code- This means a new patient visit is marked/identified by the patient completing specific code(s) and any other code completion would not be considered as a first new patient visit.

For Past Dates:

The summary view shows the total count of new patients, their first visit production and shows if those new patients, that visited in the past, have a future appointment (Scheduled Patients) or not (Unscheduled Patients). The users have the flexibility to view the report by the Treatment Provider or by Treatment Location based on the first DOS against which the new patient visit is marked. The detail view shows the patient level drill-down of each new patient including details like patient details, RP details, referral source, first and next appointment details. 

For Future Dates:

The summary view shows the total count of new patients that are scheduled for a future appointment and the scheduled production. The users have the flexibility to view the report by the Primary Appointment Provider or by the Appointment Location. The detail view shows the patient level drill-down of each new patient including details like patient details, RP details, referral source, first and next appointment details.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria is important for building your report. It allows you to focus exactly on the information you need without having to wade through the information you don’t. 

Summary View

For the New Patient report, your filter options include:

Group By* 

The Summary view of the New Patient Report can be grouped by the Treatment Provider/Treatment Location (for past days) or by Primary Appointment Provider/Appointment Location (for future dates).

Date Type* 

Users could choose to see new patients that visited the practice on a past day or could see prospective new patients scheduled for a future date. For the past date, the report is dated by the Date of Service (DOS) and filters new patients with their first DOS in the selected date range, in the past. For the future date, the report is dated by the Appointment Date and filters prospective new patients who have their first visit scheduled based on their appointment in future. This is irrespective of the New Patient Code Configuration.

Dates* 

The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. This works based on the Date Type selection.

Location* 

For past dates- Select a location or locations to focus the report based on the treatment location of the new patients, in the selected locations. 

For future dates- Select a location or locations to focus the report based on the appointment location of the prospective new patients, in the selected locations. 

Provider

For past dates- Select a provider or providers to focus the report with the selected provider(s) as the treatment provider.

For future dates- Select a provider or providers to focus the report on new patient appointments with the selected provider(s) as primary appointment provider.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Detail View

For the New Patient Detail View report, your filter options include:

Date Type* 

Users could choose to see new patients that visited the practice on a past day or could see prospective new patients scheduled for a future date. For the past date, the report is dated by the Date of Service (DOS) and filters new patients with their first DOS in the selected date range, in the past. For the future date, the report is dated by the Appointment Date and filters prospective new patients who have their first visit scheduled based on their appointment in future. This is irrespective of the New Patient Code Configuration.

Dates* 

The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. This works based on the Date Type selection.

Location* 

For past dates- Select a location or locations to focus the report based on the treatment location of the new patients, in the selected locations. 

For future dates- Select a location or locations to focus the report based on the appointment location of the prospective new patients, in the selected locations. 

Provider

For past dates- Select a provider or providers to focus the report with the selected provider(s) as the treatment provider.

For future dates- Select a provider or providers to focus the report on new patient appointments with the selected provider(s) as primary appointment provider.

Patient Type

This helps to filter out patients based on their patient type, i.e, General and Ortho.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Columns* 

This helps users to choose the relevant columns to be listed in the detailed view. Users could now select the necessary columns and print the report as per the need.

Sorting


The default sorting for the New Patient report will be by Date of Service (Asc) for past date and Appt date (asc) for future dates.

Results


Summary View Report

The report provides information grouped either by Provider or Location, based on selection. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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Related image: ./carestack-questions-2023-03-02_files/1629466567023-1629466567023.png


A consolidated total at the top of the report shows the total of new patients spread across each location or provider. The grouping of results is based on ‘Group By’ selection.

In the image, it is grouped by Location.

The result columns shown in this report include:

Patient Type

Lists patients based on the patient type as General and Ortho.

Sched Pat

This shows, out of the total new patients that were seen in the selected location/provider, how many of the patients have a scheduled future appointment (with respect to the current date).

Unsched Pat

This shows, out of the total new patients that were seen in the selected location/provider, how many of the patients do not have a scheduled future appointment (with respect to the current date). Since all the new patients in the future date type are based on the new patient appointment, this count would be zero for the future date.

Total Pat

The number of new patients based on the selected filters.

First Visit Production

This shows the total production of the new patient’s first visit. Since patients appearing in this report are yet to have their first visit for future dates, this value would be zero for future date type.

Next Appt. Sched. Prod

This shows the total production linked to the very next appointment scheduled for the new patient, in the future.

Detail View Report

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(Past Date)

Related image: ./carestack-questions-2023-03-02_files/1629466757833-1629466757833.png

(Future Date)

The result columns shown in this report include:

Patient ID

The system-assigned number used to identify this patient and their records. On clicking the ID, the user is navigated to the patient’s overview page.

Patient Name

The name of the new patient seen(past logic) or scheduled for a visit(future).

Patient Type 

The type of new patient profile- this could be General or Ortho.

Address

The address of the new patient in context.

Phone No

The patient's phone number.

Responsible Party

The name of the responsible party of the new patient. If the patient is self-responsible, it shows his/her name.

Location

The treatment location of the past visit or the appointment location of the new patient's future appointment. 

Provider

The treatment provider of the past visit or the primary appointment provider of the new patient's future appointment. 

Referral Source

Represents the referral source of the new patient who visited the practice.

First Date of Visit

This is the first DOS of the new patient based on the New patient code configuration. For future dates, this field would be blank because the prospective new patient is yet to visit the practice.

First Visit Prod

The total production created due to the first new patient visit. For future dates, this field would be blank because the prospective new patient is yet to visit the practice.

Prod. Type of First Appt

The production type of the appointment in which the new patient visit was made. For cases where new patient codes are completed without the code being linked to an appointment, this would be blank. For future dates, this field would be blank because the prospective new patient is yet to visit the practice.

Last Date of Visit

The latest DOS in which the patient visited the practice for a checkout. This could be the checked-out date due to any code completion. 

Next Appt. Date

The appointment date of the very next scheduled appointment.

Next Appt. Status

The appointment status of the very next scheduled appointment.

Next Appt. Sched. Prod

The total scheduled production from codes, added in the very next scheduled appointment.

Next Appt. Prod. Type

The production type of the very next scheduled appointment.

Use Cases


This report helps to find the following details of every new patient:

Permissions


Permissions for the New Patient report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate New Patient Report. Only users with Generate New Patient Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629466957279-1629466957279.png




Written by Abhishek Vijay | Last published at: August 23, 2021


Overview


This report is used to view procedure code statuses and other details like number of unscheduled/ scheduled codes, the fee details associated with the code, etc. This report can be used to track the list of unscheduled/ scheduled codes and can also be used to track the list of codes that was changed to a code status on the selected time range. This report shows real-time data and is available in two views- Summary View and Detail View.

The Procedures report summary view shows the number of all codes that had a status change in the selected date range against their current status. The summary view shows the number of codes that are in each code status grouped under three groups - Scheduled (linked) to an appointment, Unscheduled, and Grand total (sum of scheduled and unscheduled). 

The detail view shows the details of each code like the patient name the code is added to, the Tx provider, Tx location, the schedule status, appt date if scheduled, and fee details.

Criteria


N.B. The filters with red asterisk signs are mandatory fields

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary View

For the Procedures Summary View report, your filter options include:

Dates* 

The procedures report is dated by status change date. Select a date range to focus your report on procedure codes that have had their status changed within the selected date range.  The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day. 

Location* 

Select a location or locations to focus the report on the codes with treatment location in the selected location(s). By default, the location will be the user’s default location.

Provider Type* 

Select a provider type to focus your report on the treatment provider type of the code. You can choose between Dentist, Hygienist, in-house, or All. By default, All is selected.

Provider

Select a provider or providers to focus the report on procedure codes with the selected provider(s) as treatment provider. 

Status Last Changed To

Select statuses to focus your report-based procedure codes that last had the selected status(es) within the selected date range, whether it was previously in the Proposed, Accepted, Scheduled statuses or so on. 

Current Status

Select statuses to focus your report based on procedure codes with the selected status(es) as the current status, whether the status is now Accepted, Scheduled, Rejected, or so on.

Code

Select codes to focus your report based on the selected procedure codes.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

UCR* 

Specify whether to generate data based on procedure codes that have a UCR fee "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than or equal to $0 is selected.

Total Est.* 

Specify whether to generate data based on procedure codes with a total estimated production of "less than" "greater than" "equal to" (and so on) than your specified dollar amount (including both patient and insurance amounts). By default, greater than or equal to $0 is selected.

Detail View

For the Procedures Detail View report, your filter options include:

Dates* 

The procedures report is dated by status change date. Select a date range to focus your report on procedure codes that have had their status changed within the selected date range.  The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day. 

Location* 

Select a location or locations to focus the report on the codes with treatment location in the selected location(s). By default, the location will be the user’s default location.

Provider Type* 

Select a provider type to focus your report on the treatment provider type of the code. You can choose between Dentist, Hygienist, in-house, or All. By default, All is selected.

Provider

Select a provider or providers to focus the report on procedure codes with the selected provider(s) as treatment provider. 

Status Last Changed To

Select statuses to focus your report-based procedure codes that last had the selected status(es) within the selected date range, whether it was previously in the Proposed, Accepted, Scheduled statuses or so on. 

Current Status

Select statuses to focus your report based on procedure codes with the selected status(es) as the current status, whether the status is now Accepted, Scheduled, Rejected, or so on.

Scheduled Status*

Select status to focus your report based on procedure codes that are scheduled (linked) or unscheduled to an appointment. By default, All is selected.

Code

Select codes to focus your report based on the selected procedure codes.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

UCR* 

Specify whether to generate data based on procedure codes that have a UCR fee "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than or equal to $0 is selected.

Total Est.* 

Specify whether to generate data based on procedure codes with a total estimated production of "less than" "greater than" "equal to" (and so on) than your specified dollar amount (including both patient and insurance amounts). By default, greater than or equal to $0 is selected.

Sorting


The default sorting for the Procedures report will be by Status Change Date (desc). Sorting is possible on Status Change Date, Appt Date, UCR Fee, Est Pat, Est Ins, and Est. Fee columns as well.

Results


Summary View Report

The report provides information in column form grouped by each location selected. The first group would be consolidated total if more than one location is selected and there are codes in at least two locations. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.


Related image: ./carestack-questions-2023-03-02_files/1629467726442-1629467726442.png

The results columns shown in this report include:

Current Status

The current status of the procedure code.

#Procedures

The number of procedure codes in this status.

#Patients

The number of patients that have this procedure codes in this status in their treatment plan. 

UCR

The UCR amount calculated from these procedure codes based on your office’s standard fees. 

Total Est.

The total receivable estimated for procedure codes in this status. 

The Scheduled column includes the procedure codes that are linked to an appointment. The Unscheduled column includes the procedures codes that are not linked to any appointment.

The Grand Total column includes all procedure codes (codes that are scheduled and unscheduled). The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these appointments and their details.

Detail View Report
Related image: ./carestack-questions-2023-03-02_files/1629467809431-1629467809431.png

The results columns shown in this report include:

Patient Name

The name of the patient that has this procedure code in their treatment plan.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the advanced planner page of the patient.

Code- Description

The name of the procedure code and its description.

Current Status

The current status of the procedure code.

Status Last Changed To

The last status the procedure code was changed to within the selected time range.

Status Change Date

The date the code status was changed.

Schedule Status

This column indicates whether this code is linked to an appointment-scheduled or if not linked to an appointment- unscheduled.

Provider

The treatment provider of the listed procedure code. 

Location

The treatment provider of the listed procedure code.

Appt. Date

The date the treatment is or was scheduled.

UCR Fee

The office’s standard fee for this procedure code according to your practice settings.

Est. Pat

The estimated patient receivable.

Est. Ins

The estimated insurance receivable.

Est. Fee

The estimated total production for this procedure code.

Use Cases


Procedures reports are intended to show procedure codes that have had a status change in the selected time range. This report can be used 

Special Cases


  1. The procedures report shows procedure codes if they had a status change in the given date range.

  2. If there was multiple status changes that happened in the selected date range, the last status it was changed to in the date range and that status change date will be shown in the report.

  3. The summary view shows the current status of the procedure codes which had a status change in the selected date range. If the procedure code did not have a status change in the selected date range, that code will not be shown in this report.

Permissions


Permissions for the Procedures report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Procedure Code Detail Report. Only users with Generate Procedure Code Detail Report permission set as Yes will be able to generate the report.

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Written by Aaqib Mohammed Sali | Last published at: August 22, 2021


Credit Balance Report


The Credit Balance Report is used to find the unapplied credits in the practice. This report can be used to identify all patients with remaining credit amounts and have outstanding balances. 

This report shows real-time data. The Credit Balance report is available in two views- Summary and Detail view. 

The Summary view shows the total Unapplied Credits for each location selected is shown with the aging of credits in each aging bucket. The Detail view shows the Total Unapplied Credit amount of each patient of the selected filter and gives more information like Patient’s name, Responsible Party’s Name, Advance Payments, Account Outstanding, etc.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria is important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t.

Summary View:

For the Credit Balance Summary View Report, your filter options include:

Day*

This report is dated by the Transaction date of the receipt. By default, the date will be for the current day. The report will show the aging of credits that have been added until the specified day.

Group Credits By*

Choose whether to Group Credits By ‘Receipt Location’ (set as default) and ‘Default Location’. When the selection is the default location, all credits from receipts added in different locations would be grouped under the default location and shown. Only one entry would be created corresponding to the patient and the aging of credits would be put in each bucket in that single entry. When the selection is receipt location, it would show the unapplied credits added from each receipt location as a separate entry.

Location*

Focus the report on receipts added from the selected locations if group by receipt location is chosen or focus the report on generated at the selected location(s).

Aging Bucket*

Choose whether to generate data based on credit that has been aging. You can choose the Aging Bucket as either Till 120 or Till 180. By default, the Aging Bucket will be the Till 120.

Ind Outst.* 

Filter the report by the patients that have the individual net balance outstanding, regardless of the entire account’s balance. Specify whether to generate data based on Individual Outstanding amount of "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than equal to $0 is selected.

Patient Unapplied* 

Filter the report by the patients that have the individual patient unapplied, regardless of the entire account’s unapplied. Specify whether to generate data based on Patient Unapplied with a total amount of "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than $0 is selected.

Detail View:

For the Credit Balance Detail View Report, your filter options include:

Day

This report is dated by the Transaction date of the receipt. By default, the date will be for the current day. The report will show the aging of credits that have been added until the specified day.

Group Credits By* 

Choose whether to Group Credits By ‘Receipt Location’ (set as default) and ‘Default Location’. When the selection is the default location, all credits from receipts added in different locations would be grouped under the default location and shown. Only one entry would be created corresponding to the patient and the aging of credits would be put in each bucket in that single entry. When the selection is receipt location, it would show the unapplied credits added from each receipt location as a separate entry.

Location* 

Focus the report on receipts added from the selected locations if group by receipt location is chosen or focus the report on generated at the selected location(s).

Aging Bucket*  

Choose whether to generate data based on credit that has been aging. You can choose the Aging Bucket as either Till 120 or Till 180.  By default, the Aging Bucket will be the Till 120.

Patient Flag 

Select a Patient Flag or flag to focus the report only on patients that have the patient flag associated with the profile. These flags are determined and customized by each practice. Leave the option All to find credit balances for all patients, regardless of their flags.

Patient Type*

Leave this option as All to include all types of patients in the report or choose either the Orthodontic or General type to narrow the report to one patient type. By default, the Patient Type will be the All.

Patient

Search for and select a patient or patients to focus the report only on the balances for a specific patient or patient(s).

Responsible Party 

Search for and select a responsible party to focus the report only on the balances for a specific responsible party or party(s). 

Ind Outst.*

Filter the report by the patients that have the individual net balance outstanding, regardless of the entire account’s balance. Specify whether to generate data based on Individual Outstanding amount of "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than equal to $0 is selected. 

Account Outstanding

Type a dollar value to represent the lowest amount of outstanding account balance you want to be included in the report. Leave the amount as $0.00 to include all balances. Specify whether to generate data based on Account Outstanding amount of "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than equal to $0 is selected.

Patient Unapplied*

Filter the report by the patients that have the individual patient unapplied, regardless of the entire account’s unapplied. Specify whether to generate data based on Patient Unapplied with a total amount of "less than" "greater than" "equal to" (and so on) than your specified dollar amount. By default, greater than $0 is selected.

Columns

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


The default sorting for the Credit Balance report will be by Total Unapplied Credits.

Results


Summary View Report

The report provides information in column form grouped by location as selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

(Aging Bucket - Till 120)

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(Aging Bucket - Till 180)

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The results columns shown in this report include:

Location

Selected Location as per the selection you made in Group Credits by. The blue-colored entries are links to the detailed view of the corresponding Location entry. Click the hyperlinks to view a Detail Report listing all the credits and their details.

0-30

The dollar amount of unapplied credits that have remained unapplied for 30 days or less.

31-60

The dollar amount of unapplied credits that have remained unapplied for at least 31 to 60 days

61-90

The dollar amount of unapplied credits that have remained unapplied for at least 61 to 90 days

91-120

The dollar amount of unapplied credits that have remained unapplied for at least 91 to 120 days

121-150

The dollar amount of unapplied credits that have remained unapplied for at least 121 to 150 days

151-180

The dollar amount of unapplied credits that have remained unapplied for at least 151 to 180 days

Total Patient Unapplied Credits

The total of all unapplied credits remaining for all Patients on the selected Location.

The report also has a totals row “Total” that shows the consolidated total dollar amount of unapplied credits in each aging bucket and the total unapplied credits over all of the locations selected. 

Detail View Report

Related image: ./carestack-questions-2023-03-02_files/1629666735117-1629666735116.png

The results columns shown in this report include:

Responsible Party 

The person who is responsible for the account of the patient shown in the next column.

Resp Party ID 

The system-assigned number used to identify the Responsible Party and their records. Click this hyperlink to be taken to this Responsible Party's ledger

Patient Name

This person who was seen by the provider and who has the credit or has an outstanding balance.

Patient ID 

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to this patient's ledger.

Patient Type 

Identifies the patient as an orthodontic or general patient type.

Location

Shows the Location as per the selection you made in Group Credits by.

Indiv Outst

The dollar amount of the Balance Due Patient amount of the patient. 

0-30

The outstanding dollar amount of unapplied credits that have remained unapplied for 30 days or less.

31-60 

The outstanding dollar amount of unapplied credits that have remained unapplied for at least 31 to 60 days

61-90

The outstanding dollar amount of unapplied credits that have remained unapplied for at least 61 to 90 days

91-120

The outstanding dollar amount of unapplied credits that have remained unapplied for at least 91 to 120 days

121-150

The outstanding dollar amount of unapplied credits that have remained unapplied for at least 121 to 150 days

151-180

The outstanding dollar amount of unapplied credits that have remained unapplied for at least 151 to 180 days

Total Unapplied Credits 

The dollar value of the total of all credits for the particular patient under the responsible party. These credits have not been applied against any outstanding balance for the patient. 

Advanced Payments

The total dollar amount of advance payments collected. It would calculate the sum of all advance payment receipts and show it against the patient entry.

Acct OutSt

The dollar value of the outstanding account balance for all the patients under the responsible party. 

Acct Unapplied Credits

The dollar value of the total of all credits for all the patients under the responsible party. These credits have not been applied against any outstanding balance for any patients. 

Last Paid Date 

This column shows the date of the most recent patient payment transaction made.

Last Paid Amount

This column shows the amount of the most recent patient payment transaction made.

Special Cases


1. When the Group By default location is selected: All unapplied credits from receipts added in different locations would be grouped under the patient’s default location. Only one entry would be created corresponding to the patient and the aging of credits would be put in each bucket in that single entry.

2.When the Group By receipt location is selected: If a patient has receipts added from multiple locations then, for each receipt location an entry would be shown in the report. So the patient would have more than one entry.

Permissions


Permissions for the Credit Balance report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Credit Balance Report. Only users with Generate Credit Balance Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629666930934-1629666930934.png

Written by Aaqib Mohammed Sali | Last published at: August 22, 2021


Overview


Aging report is used to identify the patients with outstanding amounts and track the pending payable the practice has to receive from both the patient and insurance. It also shows the Net A/R the practice needs to collect.

This report shows data from the data warehouse which means it shows data as of 11:59 PM yesterday, local time. The Aging report is available in two views- Summary and Detail view. 

The summary view shows the insurance aging and patient aging and the total aging amount in different aging buckets and also shows the contracted balance and the total outstanding. The users have the flexibility to group and view the report by the treatment provider or by treatment location and this enables the user to see the outstanding amount that needs to be collected for the services against each provider or each location. Moreover, the summary view also shows the consolidated total so that you can see the aging consolidated across the practice providers and locations. The detail view shows the detailed information on the aging including the patient name, DOS of the associated aging entry, unapplied credits, carrier, the different aging bucket values, total outstanding, etc.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria is important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t.

Summary View:

For the Aging Summary View Report, your filter options include:

Group By*

Aging summary view report can be grouped by treatment location or by the treatment provider.

Day*

Select the date till which the aging needs to be shown. By default, the date will be for the current date.

Aging Bucket

Choose whether to generate data based on aging till 120 days or aging till 180 days. By default, Till 120 will be selected.

Aging Type*

Choose whether to generate the report based on Insurance aging or Patient aging or both. By default, all will be selected.

Location*

Select a location or locations to focus the report on the treatment location(s). By default, the location will be the user’s default location.

Patient Flag

Choose whether to focus your report based on patients with the selected patient flag(s).

Provider

Choose whether to focus your report on the selected treatment provider(s).

Specialty

Choose whether to focus your report on providers who have the selected specialty.

Exclude Inactive Providers

Checkmark this option if you would like to exclude Inactive Providers from the report. By default, it will be checked.

Detail View

For the Aging Detail View Report, your filter options include:

Day*

Select the date till which the aging needs to be calculated. By default, the date will be for the current date.

Aging Bucket*

Choose whether to generate data based on aging till 120 days or aging till 180 days. By default, Till 120 will be selected.

Aging Type*

Choose whether to generate the report based on Insurance aging or Patient aging or both. By default, all will be selected.

Location*

Select a location or locations to focus the report on the treatment location(s). By default, the location will be the user’s default location.

Patient Flag

Choose whether to focus your report based on patients with the selected patient flag(s).

Provider

Choose whether to focus your report on the selected treatment provider(s).

Specialty

Choose whether to focus your report on providers who have the selected specialty.

Exclude Inactive Providers

Checkmark this option if you would like to exclude Inactive Providers from the report.  

Columns*

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


Sorting is possible on Patient Id, Unapplied credits, Trans. Date, D.O.S, Aging buckets, Contracted balance, and Total outstanding columns.

Results


Summary View Report

The report provides information in column form grouped by treatment location or the treatment provider (as selected). It shows the consolidated total of patient aging and insurance aging along with the aging buckets, total outstanding balance, Net A/R across all locations or providers on top as well. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1629484028185-1629484028185.png

The results columns shown in this report include:

Aging Type

The type of aging; whether it is insurance or patient aging.

0-30

The outstanding dollar amount that has remained unpaid for 30 days or less. 

31-60

The outstanding dollar amount that has remained unpaid for at least 31 to 60 days. 

61-90

The outstanding dollar amount that has remained unpaid for at least 61 to 90 days. 

91-120

The outstanding dollar amount that has remained unpaid for at least 91 to 120 days. 

121-150

The outstanding dollar amount that has remained unpaid for at least 121 to 150 days. This field is shown only when the aging bucket Till 180 is selected.

151-180

The outstanding dollar amount that has remained unpaid for at least 151 to 180 days. This field is shown only when the aging bucket Till 180 is selected.

Over 120

The outstanding dollar amount that has remained unpaid for more than 120 days. This field is shown only when the aging bucket Till 120 is selected.

Over 180

The outstanding dollar amount that has remained unpaid for more than 180 days. This field is shown only when the aging bucket Till 180 is selected.

Contracted Balance

Contracted balance is the balance amount the patient has to pay from the contracted amount.

Total Outstanding

The total dollar amount that remained unpaid till the date selected.

Insurance Unapplied Credits

The dollar amount of insurance receipt payments that have yet to be applied towards an outstanding balance.

Patient Unapplied Credits

The dollar amount of patient receipt payments the patient has available on their account, if any, that have yet to be applied towards an outstanding balance.

Net A/R

It is the Net Account Receivable amount. This is the total outstanding - (insurance unapplied credits + patient unapplied credits).

Contracted Amount

The total amount that the patient has to pay in the payment plan.

The blue-colored entries are links to the detailed view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these aging and their details.

Detail View Report

Related image: ./carestack-questions-2023-03-02_files/1629482541877-1629482541877.png

The results columns shown in this report include:

Patient Name

The name of the patient to which this aging pertains. 

Patient Id

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to this patient's ledger. 

Unapplied Credits

The monetary credits the patient has available on their account if any.

Trans.Date

The date on which the transaction was completed in the system which has outstanding payable.

D.O.S

The date on which the patient was seen by their treatment provider for the completion of these services.

Carrier

The name of the insurance carrier associated with the insurance aging. When the patient aging is chosen as the aging type, this field would be blank.

Provider

The treatment provider who completed the services to which these aging apply. 

0-30

The outstanding dollar amount that has remained unpaid for 30 days or less. 

31-60

The outstanding dollar amount that has remained unpaid for at least 31 to 60 days. 

61-90

The outstanding dollar amount that has remained unpaid for at least 61 to 90 days. 

91-120

The outstanding dollar amount that has remained unpaid for at least 91 to 120 days. 

121-150

The outstanding dollar amount that has remained unpaid for at least 121 to 150 days. This field is shown only when the aging bucket Till 180 is selected.

151-180

The outstanding dollar amount that has remained unpaid for at least 151 to 180 days. This field is shown only when the aging bucket Till 180 is selected.

Over 120

The outstanding dollar amount that has remained unpaid for more than 120 days. This field is shown only when the aging bucket Till 120 is selected.

Over 180

The outstanding dollar amount that has remained unpaid for more than 180 days. This field is shown only when the aging bucket Till 180 is selected.

Contracted Balance

Contracted balance is the balance amount the patient has to pay from the contracted amount.

Total Outstanding

The total dollar amount that remained unpaid till the date selected.

Permissions


Permissions for the Aging report will be in System Menu ->Practice Settings ->Administration ->Profiles ->Manage Permissions ->Insights ->Under Operational Reports ->Generate Aging Report. Only users with Generate Aging Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629482541169-1629482541169.png


Written by Aaqib Mohammed Sali | Last published at: August 23, 2021


Overview


The Scheduled vs Actual Production report is used to analyze scheduling and production trends, identify areas of improvement, as well as track any remaining codes that were scheduled and not yet completed. It also identifies areas of opportunity. If a column or provider is being underutilized, you can identify this and schedule more for this provider.

The  Scheduled vs Actual Production report shows both the Scheduled Production and the Actual Production along with the percentage of Scheduled Production converted into Actual Production. This report shows real-time data and has a pivot structure. This means you can group it by one column and then drill down to the next grouping and reach into more drilled down information. The user has the flexibility to group the report by location and/or provider. 

The Scheduled production values will not have any changes for a day, it will be frozen in the morning at 5.00 am for the day, whereas the actual production is a real-time value and it will show the dollar amount of the codes when it is completed, that is when it is being added to actual production.

Criteria


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria is important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t.

Group by*

Choose to focus on whether to group your report results based on treatment location and/or treatment provider. Please note that the report results will display in the order that the data variables are selected. By default, Location, Provider is selected. 

Date range

Choose to focus the report on treatment that was scheduled and/or completed on a day that falls within the selected date range. The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day.

Location

Choose to focus the report on production scheduled for or charged out at the selected location(s). By default, the location will be the user’s default location.

Provider

Choose to focus whether to generate production data for only the selected provider(s).

Results


The report provides information in column form grouped by location as selected.

Related image: ./carestack-questions-2023-03-02_files/1629484436179-1629484436179.png


The results columns shown in this report include:

Location

The location in which the treatment was scheduled or completed.

Provider

The treatment provider of the scheduled or completed treatment. 

Date

The date on which the treatment was scheduled in the system.

Sched. Prod

The total dollar amount of production scheduled for the given date. This amount is calculated by totaling all treatments added to appointments.

Actual Production (Gross Production (DOS))

The total dollar amount of production completed on the given date. The amount is calculated from the charges of the completed codes, both those that were planned inside the appointment and those completed without an appointment.

Percentage

The percentage of Scheduled Production converted into Actual Production.

Special Cases


  1. When a code is scheduled with a treatment provider, let’s say A, the scheduled production for that provider A would be the scheduled amount of dollars for that code and if the code gets completed with the same treatment provider, his scheduled production amount will be transferred to his actual production.

  2. When a code is scheduled with a treatment provider, let’s say A, the scheduled production for that provider A would be the scheduled amount of dollars for that code and if the code gets completed with the different treatment provider, let’s say B, the scheduled production amount of the provider A will be transferred to the actual production of provider B.

Permissions


Permissions for the Scheduled vs Actual report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Scheduled vs Actual Report. Only users with  Generate Scheduled vs Actual Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629706279734-1629706279734.png

Written by Elza Ebenezer | Last published at: September 28, 2021


Overview


The Care Notes Tracker report is used to track the clinical care notes added to patient chart. This report can be run at the end of the day to see if the provider has missed out on adding care notes against the codes completed on that day and can be used to track the status of care notes added.

This report shows real-time data and shows the care notes in three ways- care notes added against codes, care notes added against codes and unlinked carenotes (care notes added to the patient chart and not linked to codes or conditions). The report has the ability to shows all the completed codes with DOS on the selected date range, the code details and shows the status of the care notes added against these codes and shows blank status if no care note was added against these codes.   

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

For the Care Notes Tracker report, your filter options include: 

Care Notes For* 

This filter allows you to view the care notes added against codes, conditions, or look at unlinked care notes added to patient. For codes, the report will show all codes added in the patient's chart and shows the corresponding care note information if any care note is linked to the code. For conditions, the report will show conditions with care notes linked to it. For unlinked, the report will show any care note that is not linked to codes or conditions. By default, Codes will be selected.

Date As* 

The care notes tracker report is dated based on the Care Notes For option selected. For codes, the Date As options include Date of Service, Added Date or by Care Note Date. For conditions, the Date As options include Added Date or Care Note Date. For unlinked, this filter is not available and the date considered would be by Care Note Date. The Date of Service would be the date the code is completed. The Added Date would be the date the code/condition is added to the patient chart. The Care Note Date is the date specified in the care note.

Date range* 

The care notes tracker report is dated by the selection on Date As filter. The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day.  

Location As* 

For codes, the Location As options include Tx location and Care Note Location. For conditions, the Location As options include condition location and Care Note Location . For unlinked, this filter is not available and the location considered would be by Care Note location. 

Location*

Select a location or locations to focus the report on the codes, conditions or care notes in the selected location(s). By default, the location will be the user’s default location.

Tx Provider

Select a provider or providers to focus the report on the selected tx provider(s), This filter is available only when care notes for codes is selected.

Appt Provider

Select a provider or providers to focus the report on the codes linked to appointment with selected appt provider(s). This filter is available only when care notes for codes is selected. This filter is available only when care notes for codes is selected. 

Cn Provider

Select a provider or providers to focus the report on the selected condition provider(s), This filter is available only when care notes for conditions is selected.

Care Note Provider

Select a provider or providers to focus the report on the selected care note provider(s).

Care Note Status

Select a location or locations to focus the report on the selected care note status(s). If no care note is added, then the status will be blank.

Show completed codes only

Select this checkbox to filter and show only completed codes and the care notes against them in this report. This filter is available only when care notes for codes is selected. 

Sorting


The default sorting for the Care notes tracker report is by column selected in Date As filter. Sorting is also possible in all date columns and patient Name.

Results


The report shows information in column form. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1632828000202-1632828000202.png

The results columns shown in this report include: 

Patient ID 

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the clinical page of the patient's profile. 

Patient Name

The name of the patient who has code, condition or care note added. 

Code 

The procedure codes that was added or completed against which the care note, if any, is added. This column is present only when Care Notes For codes is selected.

Conditions 

The condition that was added  against which the care note is added. This column is present only when Care Notes For condition is selected.

DOS 

The DOS of the procedure code.

Added Date 

The date on which the code or condition is added to the patient chart. This column is present only when Care Notes For codes or condition is selected.

Tx. Location/ Cn. Location

The treatment location of the procedure code/ condition.

Tx. Provider/ Cn. Provider

The treatment provider of the procedure code/ condition.

Appt Date 

The appt date of the appointment if the procedure code was linked to an appt. 

Appt Provider 

The primary appt provider of the appointment if the procedure code was linked to an appt.  

Code Status

The status of the procedure code. 

Template 

The name of the care note template that was added. 

Note Date 

The date specified in the linked care note

Note Provider 

The short name of the provider who is listed in the linked care note.

Assignee 

The name of the user who is listed as the assignee in the linked care note

Note Location 

The location listed in the linked care note.

Status 

The status of the care note added. This could be To Be Started, To Be Completed, To Be Reviewed, Finalized and Deleted. If no care note is added, it will be blank.

Merged 

The status of the care note added. This could be Draft or Finalized. If no care note is added, it will be blank.

Permissions


Permissions for the Care Notes Tracker report will be in System Menu -> Practice Settings -> Administration ->Profiles  ->Manage Permissions ->Insights ->Under Operational Reports ->Generate Care Notes Tracker Report. Only users with Generate Care Notes Tracker Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629626640638-1629626640638.png

 

Written by Roshni R | Last published at: August 23, 2021


Overview


The Insurance Pending Procedures report provides a list of completed procedure codes that are not being billed to insurance, completed procedures that have not been submitted on a claim yet, as well as completed services with mismatched insurances. 

This report shows real-time data. The report has two views- Summary and Detail view. The summary view shows the total count of the Completed Services Not Billed to Insurance, count of completed services with Pending Claim Creation, and count of completed services with mismatched insurances along with their Total UCR Fee and the Gross Production. The detail view shows the patient level details for these codes along with their Patient id, DOS, Insurance Status, Claim carrier, Treatment provider, etc.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the  Insurance Pending Procedures Summary View Report, your filter options include:

Condition

Select whether to generate data based on completed services that match one or more of the following conditions: 

Date Range

Choose to focus the report on services completed (DOS of code) within the selected date range. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day.

Location* 

Choose to focus the report on codes with tx location in the selected locations. By default, the location will be the user’s default location.

Provider

Choose whether to focus your report based on the selected treatment provider(s).

Carrier

Choose whether to focus your report only on the selected carrier(s).

Insurance Plan

Choose whether to generate data based on the selected insurance plan(s).

Code

Choose whether to focus your report based on the selected procedure code(s).

Patient Flag

Choose whether to focus your report based on patients with the selected patient flag(s).

Patient

Choose to focus the report based on the selected patients.

Exclude Do Not Bill to Insurance Codes

Checkmark this option if you would like to exclude procedure codes with the billing order 'N' (do not bill to insurance).

Exclude Ortho Codes Attached to Payment Plans

Checkmark this option if you would like to exclude ortho codes that are attached to Payment Plans.

Detail View

For the  Insurance Pending Procedures Detail View Report, your filter options include:

Condition

Select whether to generate data based on completed services that match one or more of the following conditions: 

Date Range

Choose to focus the report on services completed within the selected date range. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day.

Location

Choose to focus the report on codes with tx location in the selected locations. By default, the location will be the user’s default location.

Provider

Choose whether to focus your report based on the selected treatment provider(s)

Carrier

Choose whether to focus your report only on the selected carrier(s)

Insurance Plan

Choose whether to generate data based on the selected insurance plan(s)

Code

Choose whether to focus on the selected procedure code(s).

Patient Flag

Choose whether to focus your report based on patients with the selected patient flag(s)

Patient

Choose to focus the report based on the selected patients.

Exclude Do Not Bill to Insurance Codes

Checkmark this option if you would like to exclude procedure codes with the billing order 'N' (do not bill to insurance).

Exclude Ortho Codes Attached to Payment Plans

Checkmark this option if you would like to exclude ortho codes that are attached to Payment Plans.

Sorting


The default sorting for the Insurance Pending Procedures report will be by UCR fee in each condition grouping.

Sorting is possible on D.O.S, UCR Fee, and Gross Production columns as well.


Results


Summary view

The report provides information in column form. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1629640492643-1629640492643.png

The results columns shown in this report include:

Conditions

This column states whether the generated data pertains to completed codes that either was not billed to insurance, that is pending claim creation or has an insurance mismatch. The insurance is considered mismatched if the patient's insurance hierarchy has been changed while they still have an active claim out. For instance, if the primary claim was already sent out to the patient's primary insurance (Cigna), but then the patient's primary insurance plan was changed to something else (Aetna).

UCR Fee 

The total UCR calculated from these procedure codes based on the office's standard fees (according to your practice settings). 

Gross Production (DOS)

The total dollar amount of production generated according to the patient and insurance payables at the time of code completion. 

#Procedures

The total number of procedure codes with the listed condition completed within the selected time frame.

The report also has a totals row “Grand Total” that shows the consolidated totals of UCR fee, Gross Production, and #procedures. 

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these codes and their details.

Detail view

Related image: ./carestack-questions-2023-03-02_files/1629640758897-1629640758897.png

The results columns shown in this report include:

Patient Id 

The patient that has had this procedure code completed. Click this hyperlink to be taken to the Completed Procedures section of the patient's profile

Patient

The name of the patient that has had the service completed.

Code

The procedure code that was completed for this patient.

D.O.S

The date on which the patient was seen by their treatment provider for the completion of these services.

Provider

The treatment provider that completed these services for the patient.

Ins. Type

The type of insurance coverage, whether it is dental or medical. If a patient has medical insurance and dental insurance, the dental has higher priority over medical.

Ins. status 

The status of this patient's insurance plan, whether it is currently active, pending verification, or has been terminated.

B.O

The billing order of the procedure code.

Claim Type

The type of insurance claim, whether it is a dental claim or medical. 

Claim Status

The current status of the claim if any attached for these services, whether it has been Accepted, Rejected, Resubmitted, and so on. 

Carrier

The carrier pertaining to this patient's insurance plan.

Plan

The name of the patient's insurance plan as it is entered in your practice settings

Claim Carrier

The insurance carrier to which the claim was submitted. 

UCR Fee

The total UCR calculated from these procedure codes based on the office's standard fees (according to your practice settings).

Gross Production (DOS)

The total dollar amount of production generated according to the patient and insurance payables at the time of code completion.

Permissions


Permissions for the Insurance Pending Procedures report will be in System Menu -> Practice Settings ->Administration ->Profiles ->Manage Permissions ->Insights ->Under Operational Reports ->Generate  Insurance Pending Procedures Report. Only users with Generate  Insurance Pending Procedures Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629641243434-1629641243434.png


Written by Roshni R | Last published at: August 23, 2021


Overview


The Insurance Plan report lists the number of patients or insurance holders associated with a particular insurance plan.


This report shows real-time data. The Insurance plan report is available in two views- Plans and Patient view. The Plans view shows the total number of patients added against each plan including the details like Plan type, Carrier, Number of Patients with Active Ins, etc. The Patient view shows patient-level information and details like Patient’s name, Plan name, Subscriber Name, Effective Date, Active Date, Hierarchy, etc.


Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Plan view

For the Insurance Plan Plan View Report, your filter options include:

Location* 

Select a location or locations to focus the report only on insurance patients associated with the selected default location(s). By default, the location will be the user’s default location.

Insurance Type*

Choose whether to display only dental insurance, medical insurance, or both. By default, All is selected.

Plan Type

Choose whether to generate the report for only a certain type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on.

Carrier

Choose whether to generate data based on the selected insurance carrier(s).

Employer

Choose whether to generate data based on insurances associated with the selected employer(s).

Insurance Plan 

Choose whether to generate data based on the selected insurance plan(s).

Plan Status* 

Choose whether to focus your report on patient insurance that is either verified, pending verification, or choose to include all. By default, All is selected.

Patients view

For the Insurance Plan Patient View Report, your filter options include:

Location* 

Select a location or locations to focus the report only on insurance patients associated with the selected default location(s). By default, the location will be the user’s default location.

Insurance Type*

Choose whether to display only dental insurance, medical insurance, or both. By default, All is selected.

Plan Types

Choose whether to generate data for only a certain type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on.

Carrier

Choose whether to generate data based on the selected insurance carrier(s).

Employer

Choose whether to generate data based on insurances associated with the selected employer(s).

Plan Status* 

Choose whether to focus your report on patient insurance that is either verified, pending verification, or choose to include all.  By default, All is selected.

Insurance Plan 

Choose whether to generate data based on the selected insurance plan(s).

Insurance Status

Choose whether to generate data based on the selected insurance plan(s) status, whether it is Active, Draft, Inactive, Pending Verification, and so on.

Columns*

Choose the columns you wish to see in this report. By default, all columns except Insurance Type, Plan Type, Carrier, Employer, Address, and Phone Number will be selected.

Sorting


The default sorting for the Insurance Plan report is by the Plan Used By column.

Sorting is also possible on the  Plans view by  # Patients with Active Ins and possible on Patients view by Eff. Date, Term. Date, Act. Date, Family Max Remaining, Individual Max Remaining, Family Deductible Remaining, Individual Deductible Remaining, Individual Ortho Max Remaining, Individual Ortho Deductible Remaining columns as well.


Results


Plan view

The report provides information in column form. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1629641847417-1629641847417.png


The results columns shown in this report include:

Plan 

The name of the patient's insurance plan as it is entered in your practice settings. Click this hyperlink to be taken to this insurance plan's details in your practice settings. 

Insurance Type 

The type of insurance coverage, whether it is dental or medical.

Plan Type 

The type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on.

Carrier 

The carrier associated with the listed insurance plan.

Employer

The employer associated with the listed insurance plan.

Plan used by

The number of patients that have this insurance plan associated with their profile according to your selected filters. Click this hyperlink to view a Detail Report listing these patients.

#Patients with Active Ins

The number of patients that have this insurance plan marked as verified on their profile.

Plan Status

The current status of this insurance plan, whether it is verified or pending verification.

Patients view

Related image: ./carestack-questions-2023-03-02_files/1629641958728-1629641958728.png


The results columns shown in this report include:

Plan Name 

The name of the patient's insurance plan as it is entered in your practice settings. Click this hyperlink to be taken to this insurance plan's details in your practice settings. 

Insurance Type 

The type of insurance coverage, whether it is dental or medical.

Plan Type 

The type of insurance plan, whether it is PPO, Medicaid, Co-Pay, and so on.

Carrier 

The carrier associated with the listed insurance plan.

Employer

The employer associated with the listed insurance plan.

Plan Status

The current status of this patient's insurance plan, whether it is verified or pending verification.

Patient Name

The name of the Patient associated with the insurance plan. 

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Overview page of the patient's profile.

Location

The default location of the patient associated with the insurance plan.

Address

The address associated with this insurance carrier.

Phone Number

The phone number associated with this insurance carrier.

Relationship to Subscriber

The patient's relationship to the subscriber listed on their insurance plan, whether they are the spouse, the dependent child, the subscriber themselves, or so on.

Subscriber Name 

The name of the subscriber listed on this patient's insurance plan. Click this hyperlink to be taken to the subscriber's insurance page. 

Subscriber ID / SSN

The subscriber's ID or social security number used to identify the subscriber and their coverage.

Eff. Date

The date the insurance went into effect according to the information provided in the insurance details.

Term. Date

The date the insurance was set to be marked as terminated.

Act. Date

The date the insurance was marked as active in the system. 

Insurance Status

The status of this patient's insurance plan, whether it is currently active, pending verification, or has been terminated

Hierarchy

The hierarchy of this patient's insurance plan, whether it is their primary dental insurance, primary medical, secondary dental, and so on.

Family Max Remaining

The dollar amount of the family maximum remaining in the Benefits section of the Subscriber’s Insurance plan.

Individual Max Remaining

The dollar amount of the individual maximum remaining which is in the Benefits section of the Insurance plan of the patient.

Family Deductible Remaining 

The dollar amount of the family deductible remaining in the Benefits section of the Subscriber’s Insurance plan.

Individual Deductible Remaining

The dollar amount of the individual deductible remaining which is in the Benefits section of the Insurance plan of the patient.

Individual Ortho Max Remaining

The dollar amount of the individual ortho maximum remaining which is in the Benefits section of the Insurance plan of the patient.

Individual Ortho Deductible Remaining

The dollar amount of the Individual Ortho deductible remaining which is in the Benefits section of the Insurance plan of the patient.

Permissions


Permissions for the Insurance Plan report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Insurance Plan Report. Only users with Generate Insurance Plan Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629642138514-1629642138514.png


Written by Roshni R | Last published at: August 22, 2021


Overview


This report is used to find procedure codes that were missed during the checkout process. This report shows all past appointments with at least one non-completed code and checked-out appointments with no codes associated in the selected date range.


This report shows real-time data. This report shows the appointments for two scenarios: 

1) Appointment with Status “Checked Out” with no codes completed

2) Appointment is scheduled but all treatment codes linked to the appointment are not in “completed” status. 


The report shows appointment details like appointment location and time, operatory, the scheduled production of the appointment, provider, location, No. of codes linked to the appointment, etc.


Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Date range(Max 6 months)

Missing Transactions report is dated by appointment date. The date range can be selected for a maximum of 6 months. By default, the date range will be for the current day. 

Location

Select a location or locations to focus the report on the appointments in the selected location(s). By default, the location will be the user’s default location.

Provider

Select a provider or providers to focus the report on appointments with the selected provider(s) as primary appointment provider. 

Prod. Type

Choose to focus the report based on the selected Production Types.

Appt Status

Choose to focus the report based on the selected status of appointment.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Patient

Choose to focus the report based on the selected patients.

Sorting


The default sorting for the Missing Transactions report will be by Appt date (desc) and Appt time (asc). Sorting is possible on Sched. Prod and No. of Codes columns as well.

Results


Related image: ./carestack-questions-2023-03-02_files/1629642562533-1629642562533.png

The results columns shown in this report include:

Appt. Date

The date for which the appointment was scheduled to take place.

Appt. Time

The time for which the appointment was scheduled to take place.

Patient Name

The name of the patient scheduled to be seen in the appointment.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Appointments page of the patient's profile.

Provider

The primary treatment provider of the appointment

Location

The treatment location for the patient's appointment.

Operatory

The operatory for which the appointment was scheduled. 

Prod. Type

The type of production set for this appointment.

Status

The current status of the appointment.

Sched Prod

The dollar amount scheduled to be produced by the treatment(s) included in this appointment.

No. Of Codes

The total number of procedure codes linked to this appointment.

Permissions


Permissions for the Missing Transactions report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Missing Transactions Report. Only users with Generate Missing Transactions Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629642688609-1629642688609.png




Written by Roshni R | Last published at: August 23, 2021


Overview


The Patient Time Tracker report measures the amount of time the appointment itself has spent in each specified status. This report can be used to track the amount of time the patient spent in the waiting room or operatory (indicated by the appointment status used to signify this), or it can be used to track task productivity-based appointment status (such as the amount of time the appointment stayed in Left Voicemail status before the appointment was finally confirmed). 


This report shows real-time data and has two views- Summary view and Detail view. The summary view shows the average amount of time all the appointments in the specified provider location combination have spent on each status. The detail view shows more of the appointment details and shows how each appointment contributes to the time spent on the specified statuses. 


Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the Patient Time Tracker Summary View report, your filter options include:

Group By* 

Patient Time Tracker summary view report can be grouped by appointment provider or by appointment location. By default, location will be selected.

Date range* 

The report is dated by appointment date. Choose to focus the report on appointments that was scheduled on a day that falls within the selected date range. The date range can be selected for a maximum of 1 month. By default, the date range will be for the current day.

Location*

Choose to focus to generate data based on appointments scheduled at the selected treatment location. By default, the location will be the user’s default location.

Provider*

Choose to focus the report on appointments scheduled with the selected appointment provider(s). Select a maximum of up to 10 providers.

Appt. Status*

Choose to focus to generate data based on the specified appointment statuses. Select a maximum of up to 15 appointment statuses.

Detail View

For the Patient Time Tracker Detail View report, your filter options include:

Date range* 

The report is dated by appointment date. Choose to focus the report on treatment that was scheduled on a day that falls within the selected date range. The date range can be selected for a maximum of 1 month. By default, the date range will be for the current day

Location*

Choose to focus to generate data based on appointments scheduled at the selected treatment location. By default, the location will be the user’s default location.

Provider*

Choose to focus the report on appointments scheduled with the selected appointment provider(s). Select a maximum of up to 10 providers.

Appt. Status*

Choose to focus to generate data based on the specified appointment statuses. Select a maximum of up to 15 appointment statuses. 

Sorting


The default sorting for the Patient Time Tracker report will be by Appt date (desc) and Appt time (asc).

Results


Summary view

Related image: ./carestack-questions-2023-03-02_files/1629643223240-1629643223240.png

The results columns shown in this report include:

Location 

The location in which the patients were scheduled to receive treatment.

Provider 

The treatment provider for which the appointments were scheduled.

Appointment Time mins 

The total average duration (in minutes) for all appointments with this provider/location combination.

Time Spent in this Appointment Status (%)

These columns list the appointment statuses specified in the report generation criteria, along with the average time of selected appointment statuses( in minutes) with this provider/location combination and the calculated percentage relative to the total time spent in all selected statuses as a whole.

Averages 

Calculated averages are listed for the average duration (in minutes) of all appointments in the selected statuses cumulatively (for appointments scheduled for this provider or this location, dependent upon how your report is grouped). Calculated averages are also provided for the average duration (in minutes) all appointments spent in each selected appointment status (for appointments scheduled for this provider or location, dependent upon how your report is grouped).

Detail view

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The results columns shown in this report include:

Appointment Date

The date the patient was scheduled to receive treatment.

Appointment Time 

The time frame in which the patient was scheduled to be treated.

Patient Name 

The name (and patient ID) of the patient that was seen by a treatment provider.

Location 

The location in which the patient was scheduled to receive treatment. 

Operatory  

The operatory in which the patient was scheduled to be seen by a treatment provider.

Provider 

The treatment provider the patient was scheduled to see. 

Time Spent in this Appointment Status Mins.(%)

These columns list the appointment statuses specified in the report generation criteria, along with the total time of selected appointment statuses( in minutes) with this provider/location combination. 

Total Time Spent Mins. 

This column states the total amount of time the patient spent in these appointment statuses (calculating time spent in all selected appointment statuses together). 

Permissions


Permissions for the Patient Time Tracker report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Time Tracker Report. Only users with Generate Time Tracker Report permission set as Yes will be able to generate the report.

Related image: ./carestack-questions-2023-03-02_files/1629643377076-1629643377076.png


Written by Roshni R | Last published at: August 23, 2021


Overview


Pre-authorizations are used to confirm what percentage of procedure code fees the carrier will cover for the patient. With pre-authorization, you submit the treatment codes to the carrier and enquire and confirm what they will pay, instead of completing the treatment and then crossing your fingers and hoping they pay. 


The pre-authorization report is used to track the status of the pre-authorization that has been created. It allows a user to confirm pre-auth has indeed been sent, monitor the status, and schedule patients for whom pre-auths have been approved. 


This report shows real-time data and has two views- Summary view and Detail view. The summary view shows the total number of pre-auths created by their current statuses and total estimate fees for the created pre-auths grouped either by a treatment provider or treatment location. The detailed view gives the information regarding each Auth form including details like Created Date, Auth ID, Patient Name, Est. Fee, Est. Ins, Est. Pat, Auth Status, Sched. Status, Carrier Name, Plan Name, Submitted Date, Auth No, Subscriber Name, etc.


Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the pre-authorization summary view report your filter options include:

Group By* 

Pre-authorization summary view report can be grouped by treatment provider or by treatment location. 

Date Range* 

The pre-authorization report is dated by created date. The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. 

Location* 

Select a location or locations to focus the report on the pre-authorizations in the selected location(s). By default, the location will be the user’s default location.

Provider

Select a provider or providers to focus the report on pre-authorizations with the selected provider(s) as treatment provider. 

Auth status

Select an Auth status to focus the report on.

Detail View

For the  pre-authorization  Detail View report, your filter options include:

Date Range* 

The pre-authorization report is dated by created date. The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. 

Location* 

Select a location or locations to focus the report on the pre-authorizations in the selected location(s). By default, the location will be the user’s default location.

Provider

Select a provider or providers to focus the report on pre-authorizations with the selected provider(s) as treatment provider. 

Auth status

Select an Auth status to focus the report on.

Sched. Status*

Choose to focus the report on the scheduled status of the treatment on the authorization.

Columns*

Choose the columns you wish to see in this report. By default, 14 most relevant columns are selected.

Sorting


The default sorting of the Pre authorization report will be by auth ID. Sorting is also available on created date, submitted date, UCR fee, Est fee, Est. Ins, Est. pat, Actual. Ins, Actual. pat.

Results


Summary view

The report provides information in column form grouped by either treatment provider or treatment location as selected. It shows the consolidated values of all locations and providers on top as well. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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The report shows the consolidated total number of auths created in the practice split into 2 categories based on the scheduled/unscheduled status of the code.

The results columns shown in this report include:

Auth Status

The current status of the pre-authorizations, whether it is in Draft status, Completed, Rejected, and so on.

Not Scheduled - Count 

The number of authorizations created for codes that are not scheduled. 

Not Scheduled - Est. Fee

The total estimated fees for all authorizations with no scheduled procedures included. 

Scheduled - Count

The number of authorizations with at least one scheduled procedure code in this status. 

Scheduled - Est. Fee

The total estimated fees for all authorizations with at least one scheduled procedure included. 

Grand Total - Count

The grand total number of procedure codes included on authorizations in this status. 

Grand Total - Est. Fee

The grand total of estimated fees of all procedure codes included on authorizations in this status.

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these pre-auths and their details.

Detail view

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The results columns shown in this report include:

Created date

Date of creation of the pre-authorization.

Submitted date

The date on which the authorization was marked as submitted in the system.

Auth ID

The system-assigned number used to identify the unique authorization that has been generated. Click this hyperlink to open this authorization request record.

Auth No

The number given to you by the insurance carrier used to identify the specific pre-authorization estimate that has been provided. 

Patient Name

The name of the patient to which this pre-authorization pertains. 

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to the Authorizations page of the patient's profile.

DOB

The patient's date of birth according to the information specified on their patient profile.

Contact No

The patient's phone number, provided here for convenient access for your workflow needs.

Subscriber Name

The name of the subscriber listed on this patient's insurance plan.

Subscriber ID / SSN

The subscriber's ID or social security number is used to identify the subscriber and their coverage. 

UCR Fee

The total UCR fees calculated from these procedure codes on the auth are based on your office's standard fees (according to your practice settings).

Est. Fee

The estimated total receivable for the procedure codes on this preauthorization.

Est. Ins

The estimated insurance receivable for the treatment is included on this preauthorization.

Est. Pat

The estimated patient receivable for the treatment is included on this preauthorization.

Authorization Status

The current status of the pre-authorizations, whether it is in Draft status, Completed, Rejected, and so on.

Actual Ins

The estimated insurance payable as provided by the insurance carrier in the authorization response.

Actual Pat

The estimated patient payable as provided by the insurance carrier in the authorization response.

Sched. Status

The status of the treatment on the authorization, whether it has been scheduled yet or not.

Mode

The mode of the pre-authorization, whether your office has submitted it electronically or by paper. 

Location

The location in which the authorization has been generated. It is the treatment location of the codes.

Provider

The treatment provider pertaining to the procedures included on the authorization.

Provider TIN/ NPI

The treatment provider's unique identifier number is used to distinguish the eligible clinician. 

Carrier Name

The name of the insurance carrier to which this pre-authorization pertains.

Carrier ID

The carrier identifier number used to route an electronic claim to the correct destination (i.e. insurance carrier). 

Carrier Phone No

The phone number used to reach the insurance carrier (as entered in insurance details in your practice settings).

Plan Name

The name of the patient's insurance plan pertaining to this treatment and pre-authorization request.

Use Cases


The Pre-authorization report is designed to help the practice keep track of the pre-authorizations created in the practice. The report can be used to see how many pre-authorizations are created for procedures that are yet to be scheduled or are created for codes that are scheduled. This will help the practice to plan their treatments and get an idea of actions that have to be taken on the procedure code.

The fee estimates for the production will also help the practice in determining the estimate from insurance for the treatments on the pre-auths.

Permissions


Permissions for the Pre Authorization report will be in System Menu -> Practice Settings -> Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Pre Authorization  Report. Only users with Generate Pre Authorization Reporpermission set as Yes will be able to generate the report.

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Written by Roshni R | Last published at: August 23, 2021


Overview


The Production Summary report is intended to show the providers' overall production details with respect to different treatment locations. The report can be used to view each provider’s Gross Production against the total number of procedures completed under each location. Users have the flexibility to group the report by the provider or by location to see the provider production summary or the location provider summary. 


This report shows real-time data and is available in two views- Summary and Detail view. The summary view shows the total no of completed procedures, gross production, no. of appointments % of total production, etc, and shows the production summary for each provider or for each location as per the grouping. The detail view shows the patient level details along with the Code, Patient id, DOS, Patient and Insurance amount, etc that contributed to the production towards the provider and location.


Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the  Production Summary Report Summary View, your filter options include:

Date As* 

Choose to focus the report with the selected Date as the Date Of Service or Transaction Date. By default, the date will be selected as Date Of Service. On choosing the date as DOS, filter out codes with DOS in the selected date range. On choosing the date as Trans. Date, filter out all code completions, fee updates, code deletions, with transaction date in the selected date range. 

Date Range* 

Choose to focus the report within the selected date range. The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day.

Group By* 

Production summary’s summary view report can be grouped by treatment provider or by treatment location. This decides grouping the production by Location/Provider. By default, it will be set as Provider.

Treatment Location* 

Choose the locations in which the report data should be focused. By default, the location will be the user’s default location.

Provider Type* 

Choose whether to focus your report based on the selected treatment provider type. The multi-select dropdown shows Dentist, Hygienist, and In-house provider as options. This helps to filter production, fee updates, deletions by the provider type of the provider. By default, all will be selected.

Treatment Provider

Choose whether to focus your report only on the selected provider(s). By default, all will be selected.

Exclude Inactive Providers

Checking this excludes inactive providers. By default, it would be checked.

Exclude Migrated Production

Checking this excludes production entries involving MSB codes. By default, it would be checked.

Detail View

For the  Production Summary Detail View Report, your filter options include:

Date As

Choose to focus the report with the selected Date as the Date Of Service or Transaction Date. By default, the date will be selected as Date Of Service. On choosing the date as DOS, filter out codes with DOS in the selected date range. On choosing the date as Trans. Date, filter out all code completions, fee updates, code deletions, with transaction date in the selected date range. 

Date Range*  

Choose to focus the report within the selected date range. The date range can be selected for a maximum of 3 months. By default, the date range will be for the current day.

Treatment Location*  

Choose the locations in which the report data should be focused. By default, the location will be the user’s default location.

Provider Type*  

Choose whether to focus your report based on the selected treatment provider type. The multi-select dropdown shows Dentist, Hygienist, and In-house provider as options. This helps to filter production, fee updates, deletions by the provider type of the provider. By default, all will be selected.

Treatment Provider

Choose whether to focus your report only on the selected provider(s). By default, all will be selected.

Code

Choose whether to filter out codes contributing to production. By default, all will be selected.

Action

If the date as selection is as Trans. Date, the possible actions in the dropdowns are Code completion, Code deletion, and Fee updates. This field is present if the date as selected is the trans date.

Exclude Inactive Providers

Checking this excludes inactive providers. By default, it would be checked.

Exclude Migrated Production

Checking this excludes production entries involving MSB codes. By default, it would be checked.

Sorting


The default sorting for the Production Summary report will be by the DOS (desc.) or trans. Date as per the Date As filter selected. 

Results


Summary view

The report provides information in column form grouped by treatment location or treatment provider as selected. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

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The results columns shown in this report include:

Location/ Provider 

If group by selection is location, the column title will be provider and show the contribution from each provider’s split by location group.  

If the group by selection is by provider, the column title will be location and show the contribution from each location split by provider group.

Gross Production

It would list the gross production made by each provider/location. There would be a total in the end to show the group aggregate value.

#Completed Procedures

In the DOS version, it represents the number of code completions with DOS in the selected date range. In the trans. date version, it represents the number of code completions that were checked out transactionally in the selected date range.

Patients Seen

The number of patients seen by the provider in the location across the selected date range.

No. of Appointments

This lists the number of appointments in the selected date range which are in the checked-out status. If the treatment provider has an appointment linked to that code, it is considered. The distinct appointment count for multiple codes completed in the same appointment is considered.

Avg Prod ($) Per Code

This shows the Gross production/Codes completed based on DOS for DOS version and based on transactional code completions for Trans version. 

Avg Prod ($) Per Patient

This shows the Gross production/Patient seen completed.  

Avg Prod ($) Per Appt

This shows the Gross production/Number of checked-out appts. 

% of Location/Provider Production

If the group by is by Provider, this column shows % of Provider Production, by taking each location production under that provider/total production in that grouping.  If the group by is by Location, this shows % of Location Production, by taking each provider production under that location/total production in that grouping.

% of Total Production

If the group by is by Provider, this column shows % of Total Production, by taking each location production/consolidated total production. If the group by is by Location, this column shows % of Total Production, by taking each provider production/consolidated total production.

Distinct Patients Seen

In location grouping, it gives the distinct patient seen count across the selected date range, in that particular location(across all provs). In Provider Grouping, it gives the distinct patient seen count across the selected date range, by that treatment provider(across all locs).

Distinct Checked Out Appts

In location grouping, it gives the total (active) checked-out appointments in the selected date range. In Provider Grouping, it gives the total (active) distinct checked-out appointments (each day) in which the provider is the treatment provider.

% of Dentist Production

Column in Location grouping only. Total production made from providers with provider type as Dentist/total production.

% of Hygiene Production

Column in Location grouping only. Total production made from providers with provider type as hygienist/total production.

% of Inhouse Production

Column in Location grouping only. Total production made from providers with provider type as Inhouse Provider/total production.

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing these productions and their details.

Detail view

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The results columns shown in this report include:

D.O.S/ Transaction Date

The column is named as D.O.S when date as selection is Date Of Service and it is named as Transaction Date when date as selection is Transaction Date. 

Action 

This column is present if the date as selection is as Trans. Date and the possible actions applied against the code will be seen here as Code completion, Code deletion, and Fee updates.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to this patient's overview. 

Patient Name

The name of the patient that was seen for treatment.

Code

The procedure code in which the code completion, deletion, updates were made against.

Code Description

The description of the procedure code used.

Tx. Location

The location where the treatment of the code was completed, deleted or fee update was made.

Tx. Provider

The treatment provider of the code when the action was made.

Pat Amt

Patient estimate of the code. If the action is Code Deletion or if the fee update is to a decreased amount then this entry would be in Red color. You can see the amount in Red Color within Red brackets like this ($10.00)

Ins Amt

Insurance estimate of the code.  If the action is Code Deletion or if the fee update is to a decreased amount then this entry would be in Red color.

Total Amt

Sum of the total patient estimate and the insurance estimate of the code. If the action is Code Deletion or if the fee update is to a decreased amount then this entry would be in Red color.

Last Modified User

This shows the user who performed the action.

Permissions


Permissions for the Production Summary report will be in System Menu -> Practice Settings ->Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Production Summary Report. Only users with Generate Production Summary Report permission set as Yes will be able to generate the report.

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Written by Roshni R | Last published at: August 23, 2021


Overview


Utilization reports are typically used to monitor the frequency of diagnosis relative to peers or industry standards (for example the ratio of SRPs to Standard Prophy for hygienists). They are also used to assist in negotiating fees for insurance contracts (as it will show the highest volume of codes for which to focus), as well as average fee/reimbursement rates.


Utilization report is based on the Date of Service and shows real-time data. The Utilization report is available in two views- Summary and Detail view. The summary view has a pivot structure that allows you to group the information and drill down into further groupings.


Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the Utilization Summary View report, your filter options include:

Date of Service*

Focus the report on procedure codes completed within the selected date range. The user can select a maximum of up to 1 year. By default, the date range will be for the current day.

Group By*

Decide whether to group the report results based on Treatment Location, Treatment Provider, Treatment Provider Type, Primary Insurance Carrier, and/or Code. The report results will display in the order that the data variables are selected. By default, Code will be selected.

Treatment Location*

Focus the report based on the location the codes were completed in. The user can select a maximum of up to 10 locations. By default, the location will be the user’s default location.

Treatment Provider Type

Choose whether to focus your report on treatment completed by the selected provider type(s).

Treatment Provider

Choose whether to focus the report on treatment completed by the selected provider(s).

Primary Insurance Carrier

Choose whether to focus the report on procedure codes billed out to the selected insurance carrier(s).

Code

Choose whether to focus the report only on the selected procedure code(s)

Exclude Migrated Production

Checkbox this option to exclude migrated codes and their production.

Detail View

For the Utilization Detail View report, your filter options include:

Date of Service*

Focus the report on procedure codes completed within the selected date range. The user can select a maximum of up to 1 year.

Group By*

Decide whether to group the report results based on Location, Treatment Provider, Treatment Provider Type, Carrier, and/or Code or you can choose no grouping. Unlike the summary view, only one of them can be selected. By default, Treatment Location is selected.

Treatment Location*

Focus the report based on the location the codes were completed in. The user can select a maximum of up to 10 locations.

Treatment Provider Type

Choose whether to focus the report on Treatment Provider type from Dentist, Hygienist, In-house types.

Treatment Provider

Choose whether to focus the report on treatment completed by the selected provider(s).

Primary Insurance Carrier

Choose whether to focus the report on procedure codes billed out to the selected insurance carrier(s).

Code

Choose whether to focus the report only on the selected procedure code(s).

Columns*

Choose the columns which the user wishes to see in this report. By default, all the columns except Def. Provider Short Name and Def. Hygienist Short Name will be selected.

Sorting


The default sorting for the Utilization report will be by Date Of Service. Sorting is possible on Patient Name, UCR Fee, Patient Gross Production, Insurance Gross Production, Total Gross Production, Contractual Adj, Patient Applied Payment, Insurance Applied Payment, Applied Payment Columns as well.

Results


Summary view

The report provides information in column form. The report results will display in the order that the data variables in the Group By filter are selected. The user can drill through the options based on that order. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.


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You can drill down through the options as mentioned below :


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The results columns shown in this report include:

Treatment Provider 

The treatment provider of the completed procedure code

Treatment Location 

The location in which the procedure code was completed. 

Primary Insurance Carrier 

The carrier pertaining to this patient's insurance plan.

Treatment Provider Type 

The type of Treatment Provider of the completed procedure code.

Date Of Service 

The DOS of the completed code

# Codes 

The number of these procedure codes that have been completed within the selected time frame.

# Patients  

The number of patients that have had this procedure code completed within the selected time frame.

UCR 

The total UCR fees calculated from these procedure codes based on the office's standard fees (according to the practice settings).

Patient Gross Production (DOS)

The total patient responsibility according to the patient payable at the time of code completion.

Insurance Gross Production (DOS)

The total insurance responsibility according to the insurance payable at the time of code completion.

Gross Production (DOS)

The total expected receivable according to the patient and insurance payables at the time of code completion. 

Contractual Adjustment (DOS)

The contractual adjustment which is the difference between the office's standard fee and payable according to what the insurance carrier has agreed to pay. 

Avg Contractual Adjustment (DOS) 

It is the Contractual Adjustment divided by the # Codes.

Patient Applied Paid (DOS)

The dollar amount the patients have paid toward the expected receivables.

Insurance Applied Paid (DOS)

The dollar amount insurance carriers have paid toward the expected receivables. 

Avg Patient Applied Paid (DOS)

The average dollar amount your patients have paid towards this procedure code, calculated by dividing the Total Patient Paid by the Number of Codes. 

Avg Insurance Applied Paid (DOS)

The average dollar amount insurance carriers have paid towards this procedure code, calculated by dividing the Total Insurance Paid by the Number of Codes.

Applied Payments (DOS) 

The total dollar amount that has been paid toward this procedure code's expected receivables, including both patient and insurance payments.

Detail view

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The results columns shown in this report include:

D.O.S

The Date Of Service of the code.

Patient ID

The system-assigned number used to identify this patient and their records. Click this hyperlink to be taken to this patient's completed procedures.

Patient Name

The name of the patient that was seen for treatment.

Code

The procedure code that has been completed. 

Primary Insurance Carrier

The carrier pertaining to this patient's primary insurance plan.

Tx Provider Type

Shows the Treatment provider of the associated provider.

Tx Provider Short Name

Shows the Short name of the Tx provider.

Tx Provider

Shows the name of the associated provider.

Def Provider Short Name

Shows the short name of the default provider of the patient.

Def Provider

Shows the name of the default provider of the patient.

Def Hygienist Short Name

Shows the short name of the default hygienist of the patient.

Def Hygienist

Shows the name of the default hygienist of the patient.

Tx Location Short Name

Shows the short name of the treatment location.

Tx Location

Shows the treatment location.

UCR Fee

The total UCR fees calculated from these procedure codes based on your office's standard fees (according to your practice settings).

Pat. Gross Production (DOS)

The total patient responsibility according to the patient payable at the time of code completion.

Ins Gross Production (DOS)

The total insurance responsibility according to the insurance payable at the time of code completion.

Total Gross Production (DOS)

The total expected receivable according to the patient and insurance payables at the time of code completion. 

Contractual Adj (DOS)

The contractual adjustment which is the difference between the office's standard fee and payable according to what the insurance carrier has agreed to pay. 

Patient Applied Paid (DOS)

The dollar amount the patients have paid toward the expected receivables.

Insurance Applied Paid (DOS)

The average dollar amount insurance carriers have paid towards this procedure code, calculated by dividing the Total Insurance Paid by the Number of Codes. 

Applied Payment (DOS)

The total dollar amount that has been paid toward this procedure code's expected receivables, including both patient and insurance payments.

Permissions


Permissions for the Utilization report will be in System Menu -> Practice Settings -> Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Utilization Report. Only users with Generate Utilization Report permission set as Yes will be able to generate the report.

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Written by Roshni R | Last published at: August 23, 2021


Overview


The Payment Log report is used to balance and review revenue performance.

The Payment Log Report can be generated based on Transaction Date, Payment Date, or Deposit Date. This report shows real-time data. The Payment Log report is available in two views- Summary and Detail view. 

The summary view shows the consolidation of actions, applied and unapplied amount for the particular location selected. Moreover, the summary view also shows the consolidated total so that you can see the actions, applied and unapplied amount consolidated across the selected locations. The detail view gives detailed information on each action including the type, transaction date, name, payment date, deposit date, amount, etc.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the Payment Log  Summary View Report, your filter options include:

View By*

Payment Log summary view report can be viewed by Payment Category or by Payment Type. By default, the view will be for the payment category.

Date As*

Choose to run your report based on Transaction Date, Payment Date or Deposit Date. By default, the date will be the transaction date.

Date Range*

Choose to focus the report on payments dated within the selected date range (based on your choice of Transaction Date, Payment Date, or Deposit Date). Select a maximum of up to 1 month. By default, the date range will be for the current day.

Location*

Choose to focus your report based on payments entered at the selected location(s).  By default, the location will be the user’s default location.

Action

The action of the transaction done whether it was Patient Receipt Addition, Patient Receipt Deduction, Insurance Receipt Addition, Insurance Receipt Deduction, Collection Receipts, and so on. By default, all will be selected.

Paying Entity*

Choose to focus your report based on the paying entity you want to see, such as patient payments, insurance payments, or collection agency payments. By default, all will be selected.

User

Choose to focus your report based on the selected user(s) who performed the transaction.

Detail View

For the Payment Log Detail View Report, your filter options include:

Date As*

Choose to run your report based on Transaction Date, Payment Date, or Deposit Date. By default, the date will be the transaction date.

Date Range*

Choose to focus the report on payments dated within the selected date range (based on your choice of Transaction Date, Payment Date, or Deposit Date). Select a maximum of up to 1 month. By default, the date range will be for the current day.

Location*

Choose to focus your report based on payments entered at the selected location(s).  By default, the location will be the user’s default location.

Action

The action of the transaction done whether it was Patient Receipt Addition, Patient Receipt Deduction, Insurance Receipt Addition, Insurance Receipt Deduction, Collection Receipts, and so on. By default, all will be selected.

Payment Category

The category of payment, whether it was made by cash, check, credit card, and so on.  

Payment Type

Select this option to focus your report on the payment types in your practice. Only payment types with categories set as Care Credit, Cash, Check, Credit/Debit card, and direct transfer will be available for the report.

Paying Entity*

Choose to focus your report based on the paying entity you want to see, such as patient payments, insurance payments, or collection agency payments. By default, all will be selected

User

Choose to focus your report based on the selected user(s) who performed the transaction.

Columns*

Choose the columns you wish to see in this report. By default, all the columns will be selected.

Sorting


The default sorting for the Payment log report will be by Trans. Date (asc). Sorting is possible on Trans. Date, Payment Date, Deposit Date, Amount, Applied and Unapplied columns as well.

Results


Summary view

The report provides information in column form grouped by treatment location as selected. It shows the consolidated values of all locations on top as well. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.


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The columns in the Summary view include:

Applied

The dollar amount of payments that have already been applied towards an outstanding balance.

Unapplied

The dollar amount of payments that have yet to be applied towards an outstanding balance.

Amount

The total dollar amount of this payment type that has been accepted/deposited / entered/refunded / written-off (and so on) within the system during the selected time frame.

This view shows the AppliedUnapplied, and Amount of the following sections:

Patient Receipt Addition

This section lists the payment types that have been collected via patient payments within the selected date range -- along with the total dollar amount of this payment type that has been collected, the dollar amount that has already been applied towards a balance, and the remaining dollar amount that has yet to be applied towards any balance

Patient Receipt Deduction 

This section lists the patient payment types that have had a refund completed in the system within the selected date range -- along with the total dollar amount of this payment type that has been refunded. 

Patient NSF 

This section lists the patient payment types that have been marked as Non Sufficient Funds in the system within the selected date range -- along with the total dollar amount of this payment type that has been written-off due to non-sufficient funds. 

Patient Adjust-Off 

This section lists the patient payment types that have had monetary credits adjusted-off in the system within the selected date range -- along with the total dollar amount of this payment type that has been adjusted-off. 

Insurance Receipt Addition

This section lists the payment types that have been collected via insurance payments within the selected date range -- along with the total dollar amount of this payment type that has been collected, the dollar amount that has already been applied towards a balance, and the remaining dollar amount that has yet to be applied towards any balance. 

Insurance Receipt Deduction

This section lists the insurance payment types that have had a refund completed in the system or had been transferred to patients within the selected date range (along with the total dollar amount of this payment type that has been refunded). 

Collection Receipts 

This section lists the payment types that have been collected via collection agency payments within the selected date range -- along with the total dollar amount of this payment type that has been collected, the dollar amount that has already been applied towards a balance, and the remaining dollar amount that has yet to be applied towards any balance.

The blue-colored entries are links to the detail view of the corresponding entry. Click the hyperlinks to view a Detail Report listing their details.

Detail view

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The results columns shown in this report include:

Type

The type of payment, whether it is a patient payment addition or deduction, insurance payment addition or deduction, or collection agency payment addition or deduction.

Trans. Date 

The date on which the transaction was completed in the system. 

Name 

The name of the payer, whether it is a patient, insurance carrier, or collection agency. 

Payment Date

The date the payment was made.

Deposit Date

The date the payment was deposited by your office.

Receipt# 

The system-assigned number used to identify the payment that has been entered into the system. Click this hyperlink to be taken to this patient's ledger.

Location

The location pertaining to the payment that has been deposited. 

Payment Category

The category of payment, whether it was made by cash, check, credit card, and so on

Payment Type

The type of payment accepted whether it was made via Visa, Master Card, Cash, Check, and so on

Ref No. 

The reference number entered by your office staff member accepting the payment. 

Amount

The total dollar amount of the payment made.

Applied

The dollar amount of the payment that has already been applied towards an outstanding balance. 

Unapplied

The dollar amount of the payment that has yet to be applied towards an outstanding balance. 

User’s Name

The name of the user that accepted the payment and entered it into the system.

Permissions


Permissions for the Payment Log report will be in System Menu -> Practice Settings -> Administration -> Profiles -> Manage Permissions -> Insights -> Under Operational Reports -> Generate Payment Log Report. Only users with Generate Payment Log Report permission set as Yes will be able to generate the report.

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Written by Roshni R | Last published at: September 28, 2021


Overview


Payment Log Beta report is used to balance and review revenue performance.

The Payment Log Beta Report can be generated based on Transaction Date or  Payment Date and it shows real-time data. The Payment Log Beta report is available in four views- Summary view, Collection View, Transaction view, Receipt View.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Summary view

For the Payment Log Beta Summary View Report, your filter options include:

Date Range*

Choose to focus the report on payments dated within the selected date range. Select a maximum of up to 3 months. By default, the date range will be for the current day.

Date As*

Choose to focus the report on the date type to filter out the receipts based on Transaction Date & Payment Date. By default, the transaction date will be selected. 

Receipt Location*

Choose to focus the report on selecting the location filter so that the user can filter out receipts added to a specific location. By default, the user's default location will be selected.

Paying Entity*

Choose to focus your report based on the paying entity you want to see, such as patient payments, insurance payments, or collection agency payments. By default, all will be selected.

User

Choose to focus your report based on the selected user(s). By default, all will be selected.

Group Collection By*

Choose to focus the report to select the collection summary section group by. By default, the payment category should be selected. The dropdown will have the following options: Payment Category, Payment Type, Location, Payment Method, Payment Source, and None.

Show Collection By Paying Entity

Checkmark this option if you would like to include the paying entity in the report. By default, it will be checked.

Collection View

For the Payment Log Beta Collection View Report, your filter options include:

Date Range *

Choose to focus the report on payments dated within the selected date range. Select a maximum of up to 3 months. By default, the date range will be for the current day.

Date As*

Choose to focus the report on the date type to filter out the receipts based on Transaction Date & Payment Date. By default, the transaction date will be selected.

Receipt Location*

Choose to focus the report on selecting the location filter so that the user can filter out receipts added to a specific location. By default, the user's default location will be selected.

Paying Entity*

Choose to focus your report based on the paying entity you want to see, such as patient payments, insurance payments, or collection agency payments. By default, all will be selected.

Payment Category

Choose to focus your report based on the category of payment, whether it was made by cash, check, credit card, and so on.  

Payment Type

Choose to focus your report based on the type of payment accepted whether it was made via Visa, Master Card, Cash, Check, and so on.

Payment Method

Choose to focus the report based on the method of payment whether it was Regular, Advanced, Payment Plan, Patient Portal, Payment Portal, and Capitation. 

Payment Source

Choose to focus the report based on the source of the payment whether it was Bluepay, Carestack Pay, Apex Payments, None or Not Applicable. 

Patient

Choose to focus the report based on the selected patients. 

Carrier

Choose whether to focus your report on only the selected carrier(s). 

Collection Agency

Choose whether to focus your report on only the selected collection agency(s). 

User

Choose to focus your report based on the selected user(s) who created the receipt. 

Receipt Action

Choose to focus your report based on the receipt action whether it was Receipt Created, Receipt Updation, and Receipt Deletion.

Columns*

Choose the columns you wish to see in this report. 

Hide Patient Name

Checkmark this option if you would like to hide the patient name from patient payments. By default, it will not be checked.

Show Collection By Paying Entity

Checkmark this option if you would like to include the paying entity in the report. By default, it will be checked.

Group Collection by*

Choose to focus the report to select the collection group by. By default, the payment category should be selected. The dropdown will have the following options: Payment Category, Payment Type, Location, Payment Method, Payment Source, and None.

Show Receipts with Transaction Charges Only

Checkmark this option if you would like to include the receipts with transaction charges. By default, it will be checked.

Show Remarks

Checkmark this option if you would like to show the remarks against each receipt (which has a remark). By default, it will be unchecked.

Transaction View

For the Payment Log Beta Transaction View Report, your filter options include:

Date Range *

Choose to focus the report on payments dated within the selected date range. Select a maximum of up to 3 months. By default, the date range will be for the current day.

Date As*

Choose to focus the report on the date type to filter out the receipts based on Transaction Date & Payment Date. By default, the transaction date will be selected. 

Receipt Location*

Choose to focus the report on selecting the location filter so that the user can filter out receipts added to a specific location. By default, the user's default location will be selected.

Trans. Location

Choose to focus the report to select the location filter so that they can filter out specific transactions that happened at a specific location. 

Paying Entity*

Choose to focus your report based on the paying entity you want to see, such as patient payments, insurance payments, or collection agency payments. By default, all will be selected.

Transaction Action

Choose whether to generate the report based on the transaction action like Applied Payments, Refunds, Transfer Receipts, Adjust Off, Provider Adjustments, Overpayment Recovery, NSF.

User

Choose to focus your report based on the selected user(s) 

Show Transaction By Paying Entity

Checkmark this option if you would like to include the paying entity in the report.  By default, it will be checked.

Receipt View

For the Payment Log Beta Receipt View Report, your filter options include:

Receipt# 

Choose to focus your report based on the entered receipt number/id.

Show Transactions*

Choose to focus your report to show the receipt transactions by Entire Transactions or by Transactions between a certain date range. By default, the date range will be for the current day when you select the option Transactions between

Sort By*

Choose to focus the report to sort the receipt by Transaction Date or by Amount. By default, the Transaction date will be selected.

Sorting


Sorting is possible on Trans. Date, Receipt Of, Payment Date, Created User and Amount as well.

Results


Summary view

The report provides information in column form. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

The report has mainly 2 sections: Collection Summary and Transaction Summary.

Collection Summary

The collection summary section would be grouped by Paying Entity (if the user selected the group by paying Entity). Under each paying entity group section, the grouping will be done based on the selection on the Group Collection By filter.

The collection summary has the following columns:

Collected

This would show the amount collected from receipts that were added in the specified date range.

Updated (Only for transaction date)

This would show the amount which was updated on the receipts during the specified date range. 

Deleted (Only for transaction date)

This would show the dollar amount of receipts that were deleted during the specified date range.

Trans. Charge

This would show the amount of transaction charge that was collected from receipts that were added in the specified date range.

Gross collection

This will show the gross collection split on each paying entity. If the user deselects any specific paying entity then that section will be hidden. This section will show the gross collection transaction date for each paying entity and the total.

Transaction Summary

This section shows the overall utilization of the collected amount. The actions coming in this section will be Collection, Applied Payments, Refunds, Transfer Receipt, Adjustoff, Provider Adjustment, Overpayment Recovery, NSF, and Unapplied. If any of the Paying entity has value in any of these actions or else the action will be hidden.


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Collection View


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The results columns shown in this report include:

Trans. Date

The date on which the transaction was completed in the system.

Receipt Of

The name of the patient/carrier/collection agency for whom the receipt was added. This field will also have the patient ID for the patient payments. On checking hide patient name checkbox, for patient payments, only patient ID will be seen in this column.

Receipt #

The system-assigned number used to identify the payment that has been entered into the system. Click this hyperlink to be taken to the Receipt view. 

Rcp. Location

The location pertaining to the payment that has been deposited.

Payment Date

The date the payment was made as mentioned in the receipt.

Deposit Date

The date the payment was deposited by your office.

Payment Category

The category of payment, whether it was made by cash, check, credit card, and so on.

Payment Type

The type of payment accepted whether it was made via Visa, Master Card, Cash, Check, and so on

Payment Method

The method of payment accepted whether it was Regular, Advanced, Payment Plan, Patient Portal, Payment Portal or Capitation

Payment Source

The source of the payment whether it was Bluepay, Carestack Pay, Apex Payments, None or Not Applicable.

Ref No. 

The reference number entered by your office staff member accepting the payment. 

Created User

The name of the user that created the receipt and entered it into the system. 

Amount

The total dollar amount of the payment made.

Trans. Charge 

The transaction charge amount charged on receipts if any.

Advanced Rec. Provider 

The provider against which an advance receipt is tagged.

Income Reduction Provider 

The provider against which an income reduction is tagged.

Spc. Cred. Adj. Code 

If a receipt added with special credits payment type, then the adjustment code is mentioned here.

Flexi Pay

Shows yes if the receipt is a flexi pay payment.

Action

Action column will only when the date as is selected as the transaction date and shows the transaction action.

In the transaction date logic: receipt deletions will have a red value in the Amount column. Also if any receipt updations are done then the corresponding value will be in Black color which will be shown in the entries.

Transaction View

This view shows the details grouped by each transaction action for patient and insurance payments.

Each section should show the corresponding action based on the selected filters.

There is a total section at the bottom of all tables and after each grouped table.

The columns in the report include:

Trans. Date

The date on which the transaction was completed in the system.

Receipt #

The system-assigned number used to identify the payment that has been entered into the system. Click this hyperlink to be taken to the Receipt view. 

Rcp. Location

The location pertaining to the payment that has been deposited.

D.O.S

The date on which the patient was seen by their treatment provider for the completion of the services to which the receipt is applied. 

Receipt Of

The name of the patient/carrier/collection agency for whom the receipt was added.

Procedure Code

The procedure code name along with its description.

Tx Provider

The treatment provider applicable to the listed procedure code or receipt. 

Tx Location

The treatment location for the listed procedure code or receipt. 

Amount

The amount that was involved in the transaction.

Applied For 

The patient to whom this receipt is applied.

Claim ID#

The system assigned number used to identify the unique claim that has been generated. 

User's Name

The user who created the receipt

Remarks

Any remarks added if any

Refund Date

The date on which refund was made

Refund Location

The location to which the refund is made

Payment Type

The type of payment type which was made.

Patient ID

The system-assigned number used to identify this patient and their records. 

Patient Name

The name of the patient.

Refund To

Shows to whom the refund was made to -patient or insurance

Insurance Receipt Carrier

The carrier pertaining to the insurance receipt

Transfer Receipt#

The system-assigned number used to identify the transfer payment that has been entered into the system.

Transfer Receipt Location

The location to which the credit has been transferred to.

Receipt View

Related image: ./carestack-questions-2023-03-02_files/1630297463408-1630297463408.png

The report should have mainly 3 sections: Receipt Details, Transaction Details, and Transaction Summary.

Receipt Details

The user will be able to see the receipt details. The results columns shown in this report include:

Receipt Of

The name of the patient for whom the receipt was added.

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system. Click this hyperlink to be taken to the Receipt view. 

Total amount

The total amount in the receipt

Unapplied

The unapplied credits available in the receipt

User Name

The name of the user that created the receipt and entered it into the system. 

Payment Category 

The category of payment, whether it was made by cash, check, credit card, and so on.

Payment Type

The type of payment accepted whether it was made via Visa, Master Card, Cash, Check, and so on

Location

The location where the receipt is added

Payment Date

The date the payment was made

Created Date

The date the receipt was made

Deposit Date

The date the payment was deposited by your office.

Ref No. 

The reference number entered by your office staff member accepting the payment. 

FlexiPay

Mentions is the receipt addition was flexi pay

Paying Entity

If the payment was made by patient, insurance or collection agency

Payment Source

The  source of the payment whether it was Bluepay, Carestack Pay, Apex Payments, None or Not Applicable.

Payment Method

The method of payment accepted whether it was Regular, Advanced, Payment Plan, Patient Portal, Payment Portal or Capitation

Remark

Shows the remarks added to the receipt

The transaction detail section will list out all transactions (as selected in the show transaction filter) that was made on the receipt.

The transaction summary will show the summarized totals of all transaction action that was made on the receipt.

Written by Roshni R | Last published at: August 30, 2021


Overview


This report gives data points for measuring provider performance in terms of Opening and Closing Balances, Production and Collection Amounts, Adjustments, Advance Payments, and Income Reductions.

This report shows real-time data and has multiple views- Income Allocation, Gross Production, Applied Payments, Allocated Advance Payments, Adjustments, and Income Reduction.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Income Allocation view

For the Income Allocation view, your filter options include:

Group By* 

The Income Allocation view of the report can be grouped by the Treatment Provider and/or Location. By default, the Location will be selected.

Sort By 

Users could choose the sort criteria for the report which is to be generated. This report could be sorted based on provider/location Name, Gross Production or Applied Payments.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date.

Location * 

This helps to filter out transactions like production, applied payments, adjustments, advance receipts and income reduction receipts added at the selected locations.

Provider Type *

This helps to filter out transactions based on a particular provider type.

Provider

This helps to filter out transactions like production, applied payments, adjustments, advance receipts and income reduction receipts added against the selected providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Exclude Inactive Providers  

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Gross Production Summary view

For the Gross Production Summary  View, your filter options include:

Group By* 

The Gross Production view of the report can be grouped by the Treatment Provider or Location. By default, Location will be selected.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of production created.

Location * 

This helps to filter out production created at the selected treatment locations.

Provider

This helps to filter out production created by the selected treatment providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Code

This helps to filter out production created from selected code in the chosen date range.

Exclude Inactive Providers  

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Gross Production Detail view

For the Gross Production Summary  View, your filter options include:

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of production created.

Location * 

This helps to filter out production created at the selected treatment locations.

Provider

This helps to filter out production created by the selected treatment providers.

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Code

This helps to filter out production created from selected code in the chosen date range.

Exclude Inactive Providers  

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Applied Payment Summary view

For the Applied Payment Summary View, your filter options include:

Group By* 

The Applied Payment view of the report can be grouped by the Treatment Provider, Treatment Location, or Paying Entity.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Location * 

This helps to filter out payments applied at the selected treatment locations.

Paying Entity

This helps to filter out payments applied against completed codes from patient, insurance or collection agency receipt payments.

Patient 

This helps to filter out payments applied against completed codes from patient receipts added against the selected patients.

Carrier

This helps to filter out payments applied against completed codes from insurance receipts from selected carriers.

Collection Agency

This helps to filter out payments applied against completed codes from collection agency receipts from selected collection agencies.

Provider

This helps to filter out payments applied against codes completed by the selected treatment providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Code

This helps to filter out applied payments made against selected codes in the chosen date range.

Exclude Inactive Providers 

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Applied Payment Detail view

For the Applied Payment Summary View, your filter options include:

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Location * 

This helps to filter out payments applied at the selected treatment locations.

Paying Entity

This helps to filter out payments applied against completed codes from patient, insurance or collection agency receipt payments.

Patient 

This helps to filter out payments applied against completed codes from patient receipts added against the selected patients.

Carrier

This helps to filter out payments applied against completed codes from insurance receipts from selected carriers.

Collection Agency

This helps to filter out payments applied against completed codes from collection agency receipts from selected collection agencies.

Provider

This helps to filter out payments applied against codes completed by the selected treatment providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Code

This helps to filter out applied payments made against selected code in the chosen date range.

Exclude Inactive Providers 

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Allocated Advance Payments Summary view

For the Applied Payment Summary View, your filter options include:

Group By* 

The Applied Payment view of the report can be grouped by the Receipt Provider, Receipt Location.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Receipt Location * 

This helps to filter out applied payments in the selected date range from advance receipts added at the selected receipt locations. This is like a subset of transactions in the applied payment view where only those payments from advance receipts are filtered. The date range filters applied payments from advance receipts and not advance receipt creation in the selected date range.

Receipt Provider 

This helps to filter out applied payments in the selected date range from advance receipts added against the selected providers. This is like a subset of transactions in the applied payment view where only those payments from advance receipts against the selected providers are filtered. 

Treatment Location 

This helps to filter out payments applied at the selected treatment locations.

Treatment Provider

This helps to filter out payments applied against codes completed by the selected treatment providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Code

This helps to filter out applied payments made against selected code from advance receipts, in the chosen date range.

Exclude Inactive Providers

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Allocated Advance Payments Detail view

For the Applied Payment Summary View, your filter options include:

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Receipt Location * 

This helps to filter out applied payments in the selected date range from advance receipts added at the selected receipt locations. This is like a subset of transactions in the applied payment view where only those payments from advance receipts are filtered. The date range filters applied payments from advance receipts and not advance receipt creation in the selected date range.

Receipt Provider 

This helps to filter out applied payments in the selected date range from advance receipts added against the selected providers. This is like a subset of transactions in the applied payment view where only those payments from advance receipts against the selected providers are filtered. 

Treatment Location 

This helps to filter out payments applied at the selected treatment locations.

Treatment Provider

This helps to filter out payments applied against codes completed by the selected treatment providers.

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Code

This helps to filter out applied payments made against selected code from advance receipts, in the chosen date range.

Exclude Inactive Providers

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Adjustments Summary view

For the Adjustments Summary View, your filter options include:

Group By* 

The Adjustments view of the report can be grouped by the Location, Provider, or Adjustment Type.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Location * 

This helps to filter out adjustments done against treatment procedures completed in the selected locations. 

Provider 

This helps to filter out adjustments done against treatment procedures completed by the selected provider. 

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Adjustment Type *

This helps to filter out adjustments based on the type-Production or Collection.

Adjustment Against *

This helps to filter out adjustments as Insurance or Patient adjustments.

Adjustment Code

This helps to filter specific adjustment codes added in the chosen date range.

Code

This helps to filter out adjustments made against selected code in the chosen date range.

Exclude Inactive Providers

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Adjustments Detail view

For the Adjustments Summary View, your filter options include:

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Location * 

This helps to filter out adjustments done against treatment procedures completed in the selected locations. 

Provider 

This helps to filter out adjustments done against treatment procedures completed by the selected provider. 

Patient Flag

Choose to focus the report based on the patients with the selected patient flags.

Adjustment Type *

This helps to filter out adjustments based on the type-Production or Collection.

Adjustment Against *

This helps to filter out adjustments as Insurance or Patient adjustments.

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Adjustment Code

This helps to filter specific adjustment codes added in the chosen date range.

Code

This helps to filter out adjustments made against selected code in the chosen date range.

Exclude Inactive Providers

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Income Reduction Summary view

For the Income Reduction Summary View, your filter options include:

Group By* 

The Income Reduction view of the report can be grouped by the Location or Provider.

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Location * 

This helps to filter out income reduction receipts added in the selected locations. 

Provider 

This helps to filter out income reduction receipts against the selected provider. 

Patient

This helps to filter income reduction receipts added against the selected patients. 

The receipt additions are shown as positive and deletions as negative(which is opposite to that shown in the summary view)

Exclude Inactive Providers

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Income Reduction Detail view

For the Income Reduction Summary View, your filter options include:

Date Range* 

The date range can be selected for a maximum of 1 year. By default, the date range will be for the current day. This works based on the transaction date of applied payments.

Location * 

This helps to filter out income reduction receipts added in the selected locations. 

Provider 

This helps to filter out income reduction receipts against the selected provider. 

Patient

This helps to filter income reduction receipts added against the selected patients. 

The receipt additions are shown as positive and deletions as negative(which is opposite to that shown in the summary view.

Exclude Inactive Providers

Exclude inactive providers checkbox excludes transactions in the selected date range done by current inactive providers.

Results


Income Allocation view

The report provides information in column form. The report results will display in the order that the data variables in the Group By filter are selected. The user can drill through the options based on that order. 

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You can drill down through the options as mentioned below:

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The results columns shown in this report include: 

Location 

Shows the treatment location against which the transaction was made.

Provider

Treatment provider of the procedure in context.

Opening Balance 

The opening balance of outstanding charges that remained to be collected going into this selected time period. 

UCR 

The office's standard fee for this procedure code according to the practice settings.

Gross Production  

The dollar amount of production generated from procedures completed by this provider at this location. 

Production Adjustment  

The dollar amount of adjustments made against this provider's production generated at this location. 

Net Production 

The dollar amount of production generated by this provider at this location, including any production adjustments made.

Migrated Production 

The total production brought in by the MSB codes.

Applied Payments 

The dollar amount of payments that have been applied towards these balances.

Coll Adjustments 

The total dollar amount of collection adjustments made against patient and insurance receivables during this time period.

Net Applied Payment 

The total dollar amount of payments applied during this time period after any collection adjustments made. 

Closing Balance 

The remaining balance to be collected for this provider at this location, after production generated and receivables collected during this time period.

Advance Payments 

The total dollar amount of advance payments collected during this time period.

Allocated Advance Payments 

The total dollar amount allocated from the advance receipts added in the selected date range.

Provider Adj 

The total dollar amount of production adjustments completed during this time period. 

Income Reduction 

The total dollar amount of income reduction payment type added against the provider.

Gross Production Summary view

The report provides information in column form. The report results will display in the order that the data variables in the Group By filter are selected. The user can drill through the options based on that order.

Related image: ./carestack-questions-2023-03-02_files/1630301695455-1630301695455.png


You can drill down through the options as mentioned below:

Related image: ./carestack-questions-2023-03-02_files/1630301727065-1630301727065.png


The results columns shown in this report include:

Location 

Shows the treatment location against which the transaction was made.

Provider

Treatment provider of the procedure in context.

Trans. Date 

Transaction date of the action in context.

Patient Id 

Patient ID of the patient in context.

Patient Name 

Name of the patient in context.

Code 

Mentions the treatment procedure in context.

Code Desc 

The description of the procedure code completed for this patient. 

Date of Service 

The date in which the patient was seen by their treatment provider for the completion of these services. 

Action 

Shows action as ‘code completion’, ‘fee update’, or ‘code deletion’.

UCR 

The office's standard fee for this procedure code according to the practice settings.

Contractual Adjustment  

The contractual adjustment made to the payable according to the difference between the office's standard fee for this procedure and what the patient and insurance carrier has agreed to pay. 

Patient Amount  

The expected patient receivable. 

Insurance Amount  

The expected insurance receivable. 

Gross Production 

The dollar amount of gross production generated from completing this treatment.


Gross Production Detail view

Related image: ./carestack-questions-2023-03-02_files/1630301835067-1630301835067.png


The results columns shown in this report include:

Trans. Date 

Transaction date of the procedure in context.

Patient Id 

Patient ID of the patient in context.

Patient Name 

Name of the patient in context.

Location 

Shows the treatment location against which the transaction was made.

Provider

Treatment provider of the procedure in context.

Code 

Mentions the treatment procedure in context.

Code Desc

The procedure code completed for this patient, along with its description. 

Date of Service 

The date in which the patient was seen by their treatment provider for the completion of these services. 

Action 

Shows action as ‘code completion’, ‘fee update’, or ‘code deletion’.

UCR 

The office's standard fee for this procedure code according to the practice settings.

Contractual Adjustment  

The contractual adjustment made to the payable according to the difference between the office's standard fee for this procedure and what the patient and insurance carrier has agreed to pay. 

Patient Amount  

The expected patient receivable. 

Insurance Amount  

The expected insurance receivable. 

Gross Production  

The dollar amount of gross production generated from completing this treatment.


Applied Payment Summary view

The Applied Payment view shows the applied payment transactions from insurance, patient and collection agency receipts and their reversals

The report provides information in column form. The report results will display in the order that the data variables in the Group By filter are selected. The user can drill through the options based on that order.

Related image: ./carestack-questions-2023-03-02_files/1630301953404-1630301953404.png


You can drill down through the options as mentioned below:

Related image: ./carestack-questions-2023-03-02_files/1630301983372-1630301983372.png


The results columns shown in this report include:

Location 

Shows the treatment location against which the transaction was made.

Provider 

Treatment provider of the code.

Paying Entity 

Represents if it is an insurance, patient, or collection agency receipt that is in context. By default, all would be displayed.

Transaction Date 

The date the transaction was completed in the system.

Patient ID 

Identifier of the patient.

Patient Name 

Name of the patient.

Applied Payment 

The dollar amount that has been paid towards this balance.

Paying Patient 

Name of the patient from whose receipt the payment is applied.

Carrier 

Name of the insurance carrier in the context of the receipt.

Collection Agency

Name of the collection agency in the context of the receipt.

Code

Mentions the treatment procedure in context.

Code Desc 

The procedure code completed for this patient, along with its description. 

Date of Service 

The date on which the patient was seen by their treatment provider for the completion of these services. 

Patient Bal 

The patient balance at the time of checkout.

Insurance Bal 

The insurance balance at the time of checkout.

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system.

Receipt User 

The user that completed the transaction receipt in the system.


Applied Payment Detail view

Related image: ./carestack-questions-2023-03-02_files/1630302068991-1630302068991.png


The results columns shown in this report include:


Transaction Date 

The date the transaction was completed in the system.

Patient ID 

Identifier of the patient.

Patient Name 

Name of the patient.

Location 

Shows the treatment location against which the transaction was made.

Provider 

Treatment provider of the code.

Applied Payment 

The dollar amount that has been paid towards this balance.

Paying Entity 

Represents if it is an insurance, patient or collection agency receipt which is in context. By default all would be displayed.

Paying Patient 

Name of the patient from whose receipt the payment is applied.

Carrier 

Name of the insurance carrier in the context of the receipt.

Collection Agency 

Name of the collection agency in the context of the receipt.

Code 

Mentions the treatment procedure in context.

Code Desc

The procedure code completed for this patient, along with its description. 

Date of Service

The date on which the patient was seen by their treatment provider for the completion of these services. 

Patient Bal 

The patient balance at the time of checkout.

Insurance Bal 

The insurance balance at the time of checkout.

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system.

Receipt User 

The user that completed the transaction receipt in the system.


Allocated Advance Payments Summary view

The allocated advance payment view is used to see the allocated advance payments amount from advance payment receipts added against providers.

The report provides information in column form. The report results will display in the order that the data variables in the Group By filter are selected. The user can drill through the options based on that order. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

Related image: ./carestack-questions-2023-03-02_files/1630302173493-1630302173493.png

The drill downs can be selected to view the allocated advance payment amount receipt location or receipt provider or both

Related image: ./carestack-questions-2023-03-02_files/1630302219114-1630302219114.png


The result columns in the Summary view are

Receipt Location 

The Receipt location of the adv receipt in context.

Receipt Provider 

The Receipt Provider of the adv receipt in context. 

Transaction Date 

The date the transaction was completed in the system. 

Patient Id 

The Identifier of the patient that was seen for treatment. 

Patient Name 

The name of the patient that was seen for treatment.

Applied Payment 

The amount applied against the code.

Treatment Location 

Treatment location of the code.

Treatment Provider 

Treatment provider of the code.

Paying Patient 

Mentions the name of the patient who is paying the amount.

Code 

Mentions the treatment procedure in context.

Code Desc 

The procedure code completed for this patient, along with its description. 

Date of Service 

The date in which the patient was seen by their treatment provider for the completion of these services. 

Patient Bal 

The patient balance at time of checkout.

Insurance Bal

The insurance balance at time of checkout.

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system. 

Receipt User 

The user that completed the transaction in the system


Allocated Advance Payments Detail view

The detailed view shows the patient level drill down of the allocated advance payment.

Related image: ./carestack-questions-2023-03-02_files/1630302356258-1630302356258.png


The result columns in the Detailed  view are

Transaction Date 

The date the transaction was completed in the system. 

Patient Id 

The Identifier of the patient that was seen for treatment. 

Patient Name 

The name of the patient that was seen for treatment.

Applied Payment 

The amount applied against the code.

Treatment Location 

Treatment location of the code.

Treatment Provider 

Treatment provider of the code.

Paying Patient 

Mentions the name of the patient who is paying the amount.

Code 

Mentions the treatment procedure in context.

Code Desc 

The procedure code completed for this patient, along with its description. 

Date of Service 

The date in which the patient was seen by their treatment provider for the completion of these services. 

Patient Bal 

The patient balance at the time of checkout.

Insurance Bal 

The insurance balance at the time of checkout.

Receipt # 

The system-assigned number used to identify the payment that has been entered into the system. 

Receipt Location 

The Receipt location of the adv receipt in context.

Receipt Provider

The Receipt Provider of the adv receipt in context. 

Receipt User

The user that completed the transaction in the system.


Adjustments Summary view

The report provides information in column form. The report results will display in the order that the data variables in the Group By filter are selected. The user can drill through the options based on that order. Remember that you can use the tools in the top blue icon bar to move quickly through the pages or adjust the size.

The adjustment view will show all adjustments that have been applied to codes or receipt addition during the selected time period.

Related image: ./carestack-questions-2023-03-02_files/1630302456336-1630302456336.png


The drill down can be selected to view the adjustments added in locations against the provider and adjustments added by adjustment type.

Related image: ./carestack-questions-2023-03-02_files/1630302490395-1630302490395.png

The result columns in this report include.

Location

Shows the tx. location against which the adjustment was made.

Provider

The treatment provider associated with the procedure code 

Adjustment type

The adjustment type whether it was a production adjustment or collection adjustment. 

Transaction Date 

The date the transaction was completed in the system.

Patient ID 

Identifier of the patient

Patient Name  

The name of the patient that was seen for treatment.

Adj code 

The adjustment code that was made.

Adj code Desc

The adjustment code used to adjust the resulting balance for treatment completed (along with the description and action of the adjustment code).

Adjustment Against

Shows if the adjustment was made against the patient, insurance, all.

Amount  

The dollar amount of the adjustment completed. 

Code  

The procedure code completed for this patient, against which an adjustment was made.

Desc

The description of the code. 

D.O.S. 

The date on which the patient was seen by their treatment provider for the completion of these services. 

User's Name 

The user that completed the transaction in the system.

Remarks 

The remarks added while adding the adjustment.


Adjustments Detail view

Related image: ./carestack-questions-2023-03-02_files/1630302548914-1630302548914.png

The result columns in this report include.

Transaction Date

The date the transaction was completed in the system.

Patient ID 

Identifier of the patient.

Patient Name 

The name of the patient that was seen for treatment.

Adj code

The adjustment code that was made.

Adj code Desc

The adjustment code used to adjust the resulting balance for treatment completed (along with the description and action of the adjustment code).

Adjustment type

The adjustment type whether it was a production adjustment or collection adjustment.

Adjustment Against

Shows if the adjustment was made against the patient, insurance, all.

Amount  

The dollar amount of the adjustment completed. 

Location

Shows the tx. location against which the adjustment was made.

Provider

The treatment provider associated with the procedure code.

Code 

The procedure code completed for this patient, against which an adjustment was made.

Desc

The description of the code. 

D.O.S.

The date in which the patient was seen by their treatment provider for the completion of these services. 

User's Name 

The user that completed the transaction in the system.

Remarks 

The remarks added while adding the adjustment.


Income Reduction Summary view

In the income reduction summary view it only shows the receipts that have been added as payment type- Income reduction/provider payback.

Related image: ./carestack-questions-2023-03-02_files/1630302664074-1630302664074.png

Selecting the drill-downs will give the receipts for each location or provider or both.

Related image: ./carestack-questions-2023-03-02_files/1630302683390-1630302683390.png

The order of grouping would depend upon the group by option selected first. If the user selects provider and then location the  report will be grouped accordingly the same is applicable if the user selected location and then provider. Income reduction numbers are shown as positive, while deleted income reductions appear negative. This differs from the primary report.

The results in this report include.

Location

The location the payment is added.

Provider

The provider associated with receipt.

Trans Date

Shows the date of receipt addition.

Patient ID 

Identifier of the patient

Patient Name 

Name of the patient.

Payment Type

Shows the payment type of the income reduction category

Payment date

The date the practice actually received the payment

Amount

Shows the receipt amount added as income reduction.

Refunded

Shows the amount refunded from the receipt as per the current day.

Applied

Shows the amount applied from the receipt as per the current day.

Unapplied

Shows the amount remaining as credits in the receipt as per the current day.

Receipt#

Shows the receipt id in context. It is click-through content and opens the patient’s ledger in a new tab.

Receipt User

Shows the user who added the receipt.

 

Income Reduction Detail view

The Income reduction detailed view shows the patient level drill-down of the income reduction receipts that have been added in the practice.

Related image: ./carestack-questions-2023-03-02_files/1630302764393-1630302764393.png


The results in this report include.

Trans Date

Shows the date of receipt addition.

Patient ID 

Identifier of the patient

Patient Name 

Name of the patient.

Location

The location the payment is added.

Provider

The provider associated with receipt.

Payment Type

Shows the payment type of the income reduction category.

Payment date

The date the practice actually received the payment

Amount 

Shows the receipt amount added as income reduction.

Refunded

Shows the amount refunded from the receipt as per the current day.

Applied

Shows the amount applied from the receipt as per the current day.

Unapplied

Shows the amount remaining as credits in the receipt as per the current day.

Receipt#

Shows the receipt id in context. It is a click through content, and opens the patient’s ledger in a new tab.

Receipt User

Shows the user who added the receipt.



Written by Elza Ebenezer | Last published at: August 23, 2022


Area KPI  Description Trend Remarks
 Account's Receivable
 Claim Pending Submission ($) 
 The total dollar value of insurance production and insurance adjustment in claims that are pending submission.
 Not Available

 Claims Rejected ($)
 The total dollar value of insurance production and insurance adjustment in claims that are rejected.
 Not Available


 Inflated Ortho Aging

 Total balance production amount of checked-out Ortho codes with a balance that are not on an Ortho plan.

 Not Available


 Insurance AR Days
 The average number of days that it takes for a carrier to make payment on a claim. (based on first submitted date)
 Available

 Rejected Claims (Count)
 Count of distinct claims that were rejected in the specified date range

 Available in Scorecards only

 Rejection Ratio
 The ratio of rejected claims to the number of claims submitted within a given date range

 Available in Scorecards only

 Submitted Claims (Count)
 Count of distinct claims that were submitted in the specified date range

 Available in Scorecards only

 Unsubmitted Claims $
 Calculated as the insurance estimate of the claims that were created in the specified date range but are still pending submission

 Available in Scorecards only
 Appointments
 Broken Appointments

 The Total number of appointments, with appointment date in the selected date range, that are currently in the 'No Show', 'Cancelled' status.

 Available


 Broken Appointments Rate
 Total number of appointments with appointment date in the selected date range, that are currently in the 'No Show', 'Cancelled' status/ (Total number of appts that are scheduled (any custom) + No show/Cancelled appt (excluding blocked appt) in the selected date range)
 Available


 Cancelled Appointments (Current)

 The total number of appointments, with appointment date in the selected date range, that are currently in the 'Cancelled' status. 

Exclusion: Blocked slots.

 Available


 Cancellations (Percentage)
 Total percentage of appointments within a specified date range that are currently in 'Cancelled' status.

 Available in Scorecards only

 Checked Out Appointments (Current)
 The total number of appointments, with appointment date in the selected date range, that are currently in the 'Checked Out' status.
 Available


 Checked Out Production
 The total dollar amount of production from appts that was checked out in the given date range and are currently in the checked-out status
 Available


 No Show Appointments (Current)

 The total number of appointments, with appointment date in the selected date range, that are currently in the 'No Show' status.

 Available


 No Show Rates (Percentage)
 Percentage of  "no show" appointments compared to total appointments in the selected date range.

 Available in Scorecards only

 Procedures Not Linked to an Appointment
 Count of completed procedures not linked to an appointment

 Available in Scorecards only

 Rescheduled Appointments

 The total number of appointments that were rescheduled in the selected date range. However, these appointments could currently be in any other status. This KPI enables users to check if the previously rescheduled appointments have been brought on schedule. 

Exclusion: Blocked slots

 Available


 Rescheduled Appointments Rate
 Percentage of rescheduled appointments of the total scheduled.
 Available


 Scheduled Appointments

 Calculated as the count of appointments on the schedule in the selected date range. 

Exclusion: No show, Cancel, Delete, Reschedule Appointments

 Available


 Scheduled Patients

 The total number of patients having a scheduled appointment in the selected date range. 

Exclusion: No show, Cancel, Delete, Reschedule Appointments

 Available


 Scheduled Production
 Total production from codes linked to an appointment in the selected date range. 

Exclusion: No show, Cancel, Delete, Reschedule Appointments

 Available

 Clinical 
 Case Acceptance

 Percentage of case acceptance out of the total cases presented in a given date range.

 Not Available
 Care Acceptance needs to be configured in the setting tab
 Collection 

 Applied Insurance Payments (Trans. Date)

 Calculated as the 'Total Insurance Applied' +/- collection adjustments based on the transaction date.  

Inclusions: Income reduction, Transfer, and Special Credits.


 Available in Scorecards only

 Applied Patient Payments (Trans. Date)

 Calculated as the 'Total Patient Applied' +/- collection adjustments based on the transaction date.  

Inclusions: Income reduction, Transfer, and Special Credits.


 Available in Scorecards only
  
 Applied Payments (Trans. Date)
 Calculated as the total applied payments based on the transaction date, in the selected date range.
 Available


 Collection Adjustment (TXN)
 The total dollar amount of patient and insurance collection adjustments based on transaction date.
 Not Available


Collection Adjustment Rate
A measurement of Collection Adjustments (transaction date) compared to Gross Collection (transaction date) over a specified period of time.
 Not Available


 Collection Rate

 A derived indicator that determines the overall performance of collection relative to net production over a period of time, calculated by transaction date.

(Net Collection (TXN) / Net Production (TXN))* 100

 Available


 Failed Payment Plan Transactions (#)
 The number of tokenized transactions currently in failed status.
 Not Available


 Failed Payment Plan Transactions ($)

 The dollar amount of tokenized transactions currently in failed status.

 Not Available


 Gross Collection (Payment Date)

 Calculated as the total money from Patient, Insurance, and Collection Agency receipts based on payment date. 

Exclusion: Income Reduction, Transfer, and Special Credits.

 Available
 Drill Down by Location available

 Gross Collection (Trans. Date)
 Calculated as the total money from Patient, Insurance, and Collection agency receipts, based on transaction date.
Exclusion: Income Reduction, Transfer and Special Credits in receipts.
 Available


 Gross Insurance Collection (Payment Date)

 Calculated as the total money from Insurance receipts, based on the payment date specified on the receipt. 

Exclusions: Refunds, Income Reduction, Transfer, and Special Credits in receipts.


 Available in Scorecards only

 Gross Insurance Collection (Trans. Date)

 Calculated as the total money from Insurance receipts, based on transaction date. 

Exclusions: Income Reduction, Transfer, and Special Credits in receipts.

 Available


 Gross Patient Collection (Payment Date)

 Calculated as the total money from patient receipts, based on the payment date specified on the receipt. 

Exclusions: Refunds, Income Reduction, Transfer, and Special Credits in receipts.


 Available in Scorecards only

 Gross Patient Collection (Trans. Date)
 Calculated as the total money from Patient and Collection agency receipts based on transaction date.
Exclusions: Income Reduction, Transfer, and Special Credits in receipts.
 Available


 INS RECT XFER %
 The percentage value of insurance receipt transfers to patient credit, within a specified date range. The value of receipt transfers compared to the insurance collection for the same time period. Ideally, this should be less than 1%.
 Not Available


 Insurance Collection Rate (TXN)

 A derived indicator that determines the overall performance of insurance collection relative to net production over a period of time, calculated by transaction date.

(Net Insurance Collection (TXN) / Net Insurance Production (TXN))* 100

 Available


 Net Applied Insurance Payments (Trans. Date)
 Calculated as the applied payments on insurance estimates +/- collection adjustments(insurance) based on transaction date.
Inclusions: Income reduction, Transfer, and Special Credits.
 Available


 Net Applied Patient Payments (Trans. Date)

 Calculated as the applied payments on patient estimates +/- collection adjustments(patient) based on transaction date. 

Inclusions: Income reduction, Transfer, and Special Credits.

 Available


 Net Applied Payments (Trans. Date)
 Calculated as the Applied Payments +/- Collection Adjustments based on transaction date.
Inclusions: Income reduction, Transfer, and Special Credits.
 Available


 Net Collection (Payment Date)

 Calculated as the sum of money from Patient, Insurance, and Collection Agency receipts, based on payment date, +/- Collection Adjustments and Refunds with transaction date in the selected date range. 

Exclusion: Income reduction, Transfer, and Special Credits.

Gross Collection (Payment Date) - Refunds +/- Collection Adjustments

 Available


 Net Collection (Trans. Date)

 Calculated as the sum of money from Patient, insurance, and collection agency receipts+/- collection adjustments and refunds. 

Exclusions: Income reduction, Transfer, and Special Credits.

Net Collection (Trans. Date)= Gross Collection (Trans. Date) +/- Collection Adjustments - Refunds.

 Available


 Net Insurance Collection (Payment Date)

 Calculated as the Gross Insurance Collection (Payment Date)  +/- Insurance Collection Adjustments

Inclusions: Refunds, Transfer in receipts


 Available in Scorecards only

 Net Insurance Collection (Trans. Date)

 Calculated as the sum of money from Insurance receipts +/- collection adjustments(insurance-based) and refunds. 

Exclusions: Income reduction, Transfer, and Special Credits.

Net Insurance Collection (Trans. Date)= Gross Insurance Collection (Trans. Date) +/- Collection Adjustments - Refunds.

 Available


 Net Patient Collection (Payment Date)

 Calculated as the Patient Gross Collection (payment Date) +/- Patient Collection Adjustments 

Inclusions: Refunds, Transfer in receipts.


 Available in Scorecards only

 Net Patient Collection (Trans. Date)

 Calculated as the sum of money from Patient and Collection agency receipts +/- refunds and collection adjustments. 

Exclusions: Income reduction, Transfer, and Special Credits.

Net Patient Collection (Trans. Date)= Gross Patient Collection (Trans. Date) +/- Collection Adjustments - Refunds.

 Available
 

 OTC Collection
 Calculated as the total amount of patient payments collected at the time of service

 Available in Scorecards only

 OTC Rate
 The percentage of payments collected compared to the Collectable Balance of each appointment at the time of checkout. Collectable Balance is calculated to consider the Net Account Balance (Account Credits - Account Balance = Net Account Balance).
 Available


 Pat Coll Pending Allocation

 The total amount of pending unapplied patient collection where an account balance is due.

 Not Available


 Pat OverPayment
 The total amount of unapplied account credits when the patient pays more than the balance due.
 Not Available


 Patient Collection Rate (TXN)

 A derived indicator that determines the overall performance of patient collection relative to net production over a period of time, calculated by transaction date.

(Net Patient Collection (TXN) / Net Patient Production (TXN))* 100

 Available


 Same Day Allocation

 Percentage of patient balance applied to procedures on the same transaction date as the procedure code completion.

 Available
 Drill down by Location and Provider

 Unapplied Adv Pmt
 The total amount of unapplied credits from advanced payments.
 Not Available


 Unapplied Collection

 Calculated as the sum of all unapplied money from all the receipts. The total reflects the current state and is not time-specific.

 Not Available


 Unapplied Ins Collection

 Calculated as the sum of all unapplied money from insurance receipts. The total reflects the current state and is not time-specific.

 Not Available


 Unapplied Pat Collection
 Calculated as the sum of all unapplied money from patient and collection agency receipts. The total reflects the current state and is not time-specific.
 Not Available

 Front Desk 
 Accepted TX Scheduled $
 The dollar value of pending treatment added in accepted status that is linked to an appointment.
 Available

 Accepted TX Unscheduled $

 The dollar value of pending treatment added in accepted status without an appointment.

 Available


 Active Patients
 Number of active patients in the system
 Not Available


 New Patient Production %
 Calculated as the percentage of production from new patients, as compared to the gross production in the specified date range.
 Available


 New Patient Production($)

 Calculated as the dollar value production from new patients, checked out within a specified date range.

 Available


 New Patient Seen
 Calculated as the count of new patients checked out within a specified date range.
 Available


 New Patient Seen/Day

 Calculated as the average number of new patients seen per day within a specified date range.

 Available


 Proposed TX Scheduled $
 The dollar value of pending treatment added in the proposed status that is linked to an appointment.
 Available


 Proposed TX Unscheduled $
 The dollar value of pending treatment added in proposed status without an appointment.
 Available


 Patients Seen (Location)
 Unique count of patients seen per location

 Available in Scorecards only

 Recommended TX Scheduled $
 The dollar value of pending treatment added in recommended status that is linked to an appointment.
 Available


 Recommended TX Unscheduled $
 The dollar value of pending treatment added in recommended status without an appointment.
 Available

 Unscheduled Active Patients
 Count of active patients that do not have a future appointment
 Not Available


 Walkout Retention %

 The percentage of patients seen for a specified period that have a future appointment for a specific subset of codes. This KPI is most commonly used to measure the performance of the front desk in scheduling future hygiene appointments at the time of walkout. We'll need to specify a code filter for historical segmentation and a code filter for future appointments to see the efficiency in scheduling.

 Available
 Additional Setup Available

Patient Attrition Rate
The percentage of patients that have been flagged as 'Inactive' within a specified date range, mostly due to a lack of activity, when compared to the active patients.
 Available



Patient Reactivation Rate
The percentage of ‘Active’ patients that were previously flagged as ‘Inactive’ prior to the specified date range.
 Available

 Production
 Adjusted Insurance Production (Trans. Date)
 Calculated as the net insurance production adjusted to remove inflated ortho production that was not set up using an ortho payment plan.
 Available


 Adjusted Patient Production (Trans. Date)
 Calculated as the net patient production adjusted to remove inflated ortho production that was not set up using an ortho payment plan.
 Available


 Adjusted Production (Trans. Date)

 Calculated as the net production adjusted to remove inflated ortho production that was not set up using an ortho payment plan.

 Available


 Average Daily Production (Location)

 The average gross production checked out per working day within a specified time period where a working day is calculated based on the DOS of the completed charges.


 Available in Scorecards only

 Average Daily Production (Provider)

 The average gross provider production checked out per working day within a specified time period where a working day is calculated based on the DOS of the completed charges.


 Available in Scorecards only

 Average Production Per Appointment

 The average gross production checked out per appointment within a specified time period.


 Available in Scorecards only

 Avg Prod Per Appt

 Net Prod linked to completed appts (appt date)/ Total Completed Appts (appt date)

 Available


 Avg Prod Per Day
 Net Prod (trans date)/ Working days.
Working Days:- Total Days with min two completed appointments (by Appt Date)
 Available


 Gross Insurance Production (DOS)

 The total dollar value of insurance payable of completed procedures, based on the date of service. 

Exclusion: Migrated balances (MSB codes)

 Available


 Gross Insurance Production (Trans. Date)
 The total dollar value of insurance payable of completed procedures, based on transaction date of code completion.
Exclusion: Migrated balances (MSB codes)
 Available


 Gross Patient Production (DOS)
 The total dollar value of patient payable of completed procedures, based on the date of service.
Exclusion: Migrated balances (MSB codes)
 Available


 Gross Patient Production (Trans. Date)

 The total dollar value of patient payable of completed procedures, based on transaction date of code completion. 

Exclusion: Migrated balances (MSB codes)

 Available


 Gross Production (DOS)
 Total dollar value from completed procedures based on the date of service.
Exclusion: Migrated balances (MSB codes)
 Available
 Drill down available on all default filters

 Gross Production (Trans. Date)

 Total dollar value from completed procedures based on transaction date of code completion. 

Exclusion: Migrated balances (MSB codes)

 Available


 Migrated Production (DOS)
 Calculated as the total payable from Migrated Starting Balance codes with DOS in the given date range.

 Available in Scorecards only

 Migrated Production (Trans. Date)
 Calculated as the total payable from Migrated Starting Balance codes with transaction date in the given date range.

 Available in Scorecards only

 Net Insurance Production (DOS)

 Final dollar value after reducing production adjustments from insurance payable of completed procedures based on the date of service of codes in the selected date range.

 Available


 Net Insurance Production (Trans. Date)
 Final dollar value after reducing production adjustments from insurance payable of completed procedures based on transactions in the selected date range.
 Available


 Net Patient Production (DOS)

 Final dollar value after reducing production adjustments from patient payable of completed procedures based on the date of service of codes in the selected date range.

 Available


 Net Patient Production (Trans. Date)
 Final dollar value after reducing production adjustments from patient payable of completed procedures based on transactions in the selected date range.
 Available


 Net Production (DOS)

 Final dollar value after reducing production adjustments from Gross Production (DOS).

 Available


 Net Production (Trans. Date)

 Final dollar value after reducing production adjustments from total payable of completed procedures based on transactions in the selected date range.

 Available


 Production Adjustment (TXN)
 The total dollar amount of patient and insurance production adjustments based on transaction date.
  Not Available


Production Adjustment Rate
A measurement of Production Adjustments (transaction date) compared to Gross Production (transaction date) over a specified period of time.
  Not Available



 UCR Total
 Calculated as the sum of UCR of all completed procedures with DOS in the given date range

 Available in Scorecards only

Written by Aaqib Mohammed Sali | Last published at: August 23, 2021


Overview


Patient Lists is a list generator present within the Insights module. It is easily accessible from the main menu and it allows the users to save frequently used criteria as templates. 


The uses of the generated lists include but are not limited to appointment reminders, appointment confirmations, payment reminders.


Users


The users of patient lists are spread across different profiles. The ones that use it most frequently include front office staff for appointment reminders, confirmation, and verification as well as billing and insurance staff to keep track of outstanding payments and send payment reminders.

Permissions


The permissions for patient lists are located within Patient segmentation in the Permissions screen. The related permissions are as follows:

Workflow


The patient lists options from the main menu takes the user to a general page with a list of saved patient list templates. 

Related image: ./carestack-questions-2023-03-02_files/1629471232370-1629471232370.png

These templates may be viewed or modified or deleted from this screen. Similarly, there are options to generate a new list or view the scheduled downloads on the top right corner of the screen.


Clicking on the template name of a saved template will open a screen with pre-selected fields as was saved the last time the template was modified. Similarly, clicking on the “Generate New List” button will also take the user to the same screen.
Related image: ./carestack-questions-2023-03-02_files/1629471254051-1629471254051.pngClicking on the hyperlink listed under step up will open a slideout with options and sub-options like in a tree hierarchy. Different combinations of the options chosen by the user will be the criteria defined for the list to be generated. 

Related image: ./carestack-questions-2023-03-02_files/1629471291815-1629471291815.png

The user may add any number of such filters and it will add to the existing combination using an “AND” operator further narrowing down the scope of the patients in the required list. 


The filter for active patients are pre-filled on this slideout as a default filter but this may be removed by the user if required.


Once the criteria has been set, and user clicks on done, the slideout closes to reveal the previous screen. The selected criteria will be listed under step 1 and a link to edit the criteria will be present alongside it.
Related image: ./carestack-questions-2023-03-02_files/1629471325061-1629471325061.pngThe next step would be to choose the required columns for the list. There are checkboxes related to Basic Information, Appointment Information and Contact Information of the patient. Checking the required checkboxes will allow the user to add those as columns to the list. A maximum of 10 columns can be selected per list.

The user then has the option to simply generate the list as per the criteria and columns selected or the user may save the template for future use along with generating the list to avoid having to make each of these selections each time they have the same requirement.


On clicking the “Save and Generate” button, a dialog box appears for the user to provide a name and description for the saved list template. 

Related image: ./carestack-questions-2023-03-02_files/1629469278581-1629469278581.png

On providing a list name and clicking save, the template is saved and the list is generated. If the “Generate” button is clicked, then the dialog box is skipped and the template is not saved.

On the generated list page, the user has the option to export the list as a CSV file or the user may select the patients using checkboxes and send text messages using the Actions dropdown.
Related image: ./carestack-questions-2023-03-02_files/1629471412313-1629471412313.png

While exporting the list, the user may opt for additional columns that were not available in the initial set of options during generation.
Related image: ./carestack-questions-2023-03-02_files/1629471426694-1629471426693.png

Similarly, dynamic list generation has a limit of 1000 rows. If the criteria used for generation is such that the list contains more than 1000 rows, then only the top 1000 will be displayed and the entire list will be available on exporting. This will be indicated using a warning on top of the generated list.


Related image: ./carestack-questions-2023-03-02_files/1629469278147-1629469278147.png

Patient list Criteria will give a detailed explanation of the different options available to the user while setting the filter criteria for list generation.

Written by Elza Ebenezer | Last published at: September 29, 2021


Overview  


The Intel Report is used as the client consultation platform which the Account Management & Client success team leads. With the Intel Report, the user can monitor prime KPIs and track how these KPIs perform as compared to the defind recommended rates.

The report shows data warehouse data, meaning the data till the last day. Intel report shows the KPI, its value, trend, and performance against the recommended rate.

Criteria 


N.B. The filters with red asterisk signs are mandatory fields.

Setting the filter criteria important for building your report. It allows you to focus on exactly the information you need without having to wade through the information you don’t. 

Date Range* 

The date range that can be selected are YTD, QTD, MTD, WTD, Yesterday, Previous 6 Calendar Months, Previous 3 Calendar Months, and Previous Calendar Month. By default, MTD will be selected.

KPI Trend*

Choose to show the KPI trend by previous period or by previous year. By default, Previous period is selected. 

Results


Related image: ./carestack-questions-2023-03-02_files/1632906245614-1632906245614.png

KPI 

The name of the KPI. The Intel report shows a total of 14 KPIs.

Value

The value of the KPI in the specified date range.

Trend

The trend of the KPI with the previous period/ previous year data. For KPIs with no trend option, this column would be blank. 

Performance

The performance of the KPI value compared with the defined recommended rates. The recommended rates are also shown in this column. If no recommended rate is defined, then this column would be empty. 

Permissions


The permissions for the Intel report will be in System Menu -> Practice Settings -> Administration -> Profiles -> Manage Permissions -> Insights -> Analytics Dashboard -> View Analytics Dashboard. 

Related image: ./carestack-questions-2023-03-02_files/1632907099896-1632907099896.png

Written by Rahul Krishnan | Last published at: August 15, 2021


Callpop is a third party application which helps in the integration between practice management software like CareStack and existing phone system which enables the practice to communicate with patients seamlessly thereby enabling the practice to increase their profit margins as well as enrich the customer experience.

Callpop integrates with the CareStack software to launch a patient's profile the moment they call, eliminating the need to spell names or search through patient records. This awesome feature is included with your CareStack subscription at no additional charge.

Related image: ./carestack-questions-2023-03-02_files/1628862585601-1628862585601.png


Related image: ./carestack-questions-2023-03-02_files/1628862645307-1628862645307.png

The client will need the following information when beginning their Callpop setup:

Once the Callpop setup is initiated, the final integration steps will need to be completed on the back-end by our Development team before the client can begin to use this feature with CareStack. 

Definitions

Written by Jay KV | Last published at: July 17, 2021


Patient Services

Major Features - Release 5.21


Text Chat Migration to Iris.


Beta Release

As per the current plan, we will push for a beta by the end of the 5.21 Release. We will follow this up with the full rollout in 5.22.


Patient Connect


Beta Release

The first round beta of patient connect is expected to be out in 5.20, we will have another beta in 5.21 and follow it up with the release in 5.22


Patient Engagement Enhancements


Document Sharing



Forms Reminders and the Ability to fill forms without a login


Major Features - Release 5.22

Medical Hx forms Revamp

Text Message FUP


Pre-loaded set of campaigns, template library for promotional campaigns, and intelligent template suggestions.


Reputation Management - Social Media Integration 


Online Appointments - Book multiple slots



Reporting & Analytics

Roadmap View


Related image: ./carestack-questions-2023-03-02_files/1626526575896-1626526575896.png


Roadmap Items:

5.21 Release


Aging Beta

The new Aging Report(Beta) gives users the flexibility to configure the aging logic, based on the practice requirements. This new report with enhanced features, has been found to be a gamechanger for practices wanting to calculate aging in Carestack, based on their definition. This also means that all the clients in Carestack are the target clients that would be impacted by the new report. While there seems to be considerable effort in building the new Aging Report, the report is expected to be released by 5.21.There is no specific release strategy for this new functionality.


Scorecard UX

The UI and UX rework on scorecards is aimed at providing a more usable easy experience while monitoring the relevant metrics on scorecards. This is released for all customers and is expected to be released by 5.21.


New KPIs

New KPIs relevant to be tracked by practises to stay on top of the charts are planned to be released by 5.21. This is released for all customers through a normal release strategy. 


KPI Drill Ins

An enhanced drill in that provides the capability to view upto a patient level details on some of the existing dashboard KPIs. This is released for all customers through a normal release strategy, but would be impacting customers with the Custom Dashboard feature enabled. This is expected to be released by 5.21.


Beta Reports Feedback

With 5.21, all the old payment log and income allocation report in Insights would be decommissioned and removed. Users could use their corresponding enhanced beta reports as the main report to find data points they are interested in. This is targeted to impact all customers.


Legacy Report Decommissioning

Along with the decommissioning of legacy reports, we would be accommodating in the initial feedbacks in the Income Allocation and Payment Log Beta reports. This is targeted to impact all customers planned through a normal release strategy to be live by 5.21.


Interactive Filters

With the use of interactive filters in reports, users could look at only relevant data points rather than listing all filters that might not be in the context of the selection. This framework change of providing advanced experience would impact all clients. This is planned to be released for all customers through a normal release strategy and is expected to be live by 5.21.


5.22 Release


Canned scorecards

Canned scorecard is a high value analytics packaging that provides multiple templates like Health Summary, Production scorecards, etc, for practices to keep an eye on the performance and trends of these metrics. A location and provider level view of these metrics provide a holistic view of practice analytics. This is planned to be released for all customers through a normal release strategy. The initial version of it is expected to be released by 5.22 and the remaining versions are planned in the subsequent releases.


New KPIs

New KPIs relevant to be tracked by practises to stay on top of the charts are planned to be released by 5.22. This is released for all customers through a normal release strategy. 


Appointments by Provider Report(Enhancement)

The appointments by provider report, in its current structure, shows inconsistent data. This is planned to be enhanced by fixing the inconsistencies and planned to provide additional functionalities. This is planned to be released for all customers through a normal release strategy and is expected to be live by 5.22.


New Patient Report(Enhancement)

The new patient report is found to have specific use cases that is how practices see the new patient report. The new mode and additional filtering options are expected to add value to all customers. This is planned to be released for all customers through a normal release strategy and is expected to be live by 5.22.


Refer In Report(Enhancement)

The current Refer In Report lacks the functionality to view the referred patients based on referral sources. Filtering based on referral source subcategory is what is achievable in the current report but the need to filter by referral source has been raised by multiple clients. There are additional pending enhancements like interactive filters and new data points that would be added to this enhanced report. This is planned to be released for all customers through a normal release strategy and is expected to be live by 5.22.


Carenote Tracker Report

The Carenote Tracker Report is planned to be enhanced with additional functionality that tracks all carenotes added in the system, be it against a code, condition or an unlinked carenote. This is planned to be released for all customers through a normal release strategy and is expected to be live by 5.22.


CLINICAL 


5.21


CareNote revamp



Recalls



Treatment History 




5.22


Referral Portal




SOTA Enhancements



5.23


Perio Enhancements




Quality Care



Clinical Images




Front Office 


Appointment Booking and Cancellation




Calendar




Written by Aravind M | Last published at: October 01, 2021


Key Features Upcoming in CS 5.22

Check out this list of features and enhancements coming in CS 5.22!

Clinical






             Front Office








Patient Services





Reporting





RCM






Written by Aravind M | Last published at: December 03, 2021


Key Features Upcoming in CS 5.23

Check out this list of features and enhancements coming in CS 5.23!


Clinical





            Front Office





Patient Services




Reporting




RCM




Written by Aravind M | Last published at: February 16, 2022


Key Features Upcoming in CS 5.24

Check out this list of features and enhancements coming in CS 5.24!

Clinical







             Front Office





Patient Services




Reporting



RCM






Written by Aravind M | Last published at: July 04, 2022


Key Features Upcoming in CS 5.26

Check out this list of features and enhancements coming in CS 5.26!


Clinical





             Front Office




Patient Services



The kiosk mode of the Patient Connect has been revamped to a more intuitive patient-facing application that allows for a faster check-in process for a patient’s appointment. Below listed are the key features.


Reporting




RCM






Written by Aravind M | Last published at: July 04, 2022


Release Features 527.pdf

Written by Aravind M | Last published at: October 03, 2022


Release Features 5_28.pdf

Written by Akhila R | Last published at: July 28, 2021


Overview

                  Patient portals are healthcare-related  online platforms that  allows patients to interact with their provider or practice , regarding their medical information and related business via the Internet. Patient portals benefit both patients and providers by increasing efficiency and productivity. Our patient portal is also a similar platform where patients are able to access medical records, make payments and complete forms via an email. They can access it from anywhere and everywhere!!!

How to access patient portal?

           If the patient wishes to receive patient portal emails, user will have to update the 'Enable Portal Notifications' checkbox in the new patient window(fig.1).  After patient gets subscribed for 'Enable Portal Notifications', 'Check Patient Portal Status' button in patient overview will show that the patient portal is active.


Related image: ./carestack-questions-2023-03-02_files/1627312813410-1627312813410.png

                                         fig. 1: Enable Portal Notification checkbox


                        User can send a patient portal email to patient by clicking 'Send Patient portal link' in overview. The email  will contain a link  to visit the portal, and on clicking  the URL in mail patient is redirected to the patient portal login page where they can generate the one time authentication code. This figure shows both link in patient overview and a sample email that patient will receive in their device.

Related image: ./carestack-questions-2023-03-02_files/1627313573789-1627313573789.png

                                  fig. 2 (a) : Send patient portal link in patient overview

Related image: ./carestack-questions-2023-03-02_files/1627313613809-1627313613809.png

                                  fig.2 (b) : Example of a Patient portal email with URL

Also there is a generic link for each practice to navigate to an authentication page where patients can identify themselves after providing first name, last name and date of birth as shown below. The given steps  shows how a patient can login to patient portal.

Step 1: In the authentication page patient can provide first name , last name and date of birth which are mandatory and then click next.( fig.3)

Related image: ./carestack-questions-2023-03-02_files/1627314184826-1627314184826.png                                            fig.3: Patient portal authentication page

Step 2:After giving the credentials patient should be able to generate an one time authentication code via email or text as per their choice. Patient can select a medium though which they would like to receive the OTP and can click 'GET VERIFICATION CODE' button.(fig.4)

Related image: ./carestack-questions-2023-03-02_files/1627314498590-1627314498590.png                                               fig.4: Next page to select medium


Step 3: Patient can type OTP and then click proceed.

What can patients do with Patient portal?

                             Patient portal should improve both patient care and provider workflow .It should be user friendly and at the same time should have a  workflow that saves time and effort for staff and providers. The home page of portal comes with a welcome banner, consolidated payment data ,upcoming appointments , pending forms and treatment pending. There are some side tabs like forms, treatments, payments and  appointments ( fig.4) .If the patient is a responsible party they can switch the context to another patient linked to the account by clicking 'Select Family Member'.

Related image: ./carestack-questions-2023-03-02_files/1627316195096-1627316195096.png

                                              fig.4: Home page of Patient portal

Patient portal tabs:

Home: A patient on logging in to portal lands on the home page by default . It contains  4 different sections as payments, upcoming appts, pending forms and treatment pending.

Forms: This section is titled pending forms and user can search any form from here. Incomplete forms of a patient will be listed in the home page.  Once a form is completed, it is removed from the pending forms section.

Treatments: This section contains treatment plan, upcoming treatment and past treatment. The upcoming treatments shows upcoming treatments pertaining to the selected patient and past treatments show the completed ones.

Payments: Responsible party is able to see their saved payment details along with payment history and statement history. They can view and can make payments from here by clicking 'Pay now' button corresponding to each account member.

Appointments: It contains two different tabs as upcoming and past appointments. Upcoming appointments list all the appointments of patient for the a future date or for the same day. Patient can confirm their appointment from the portal by clicking 'Confirm Now' button. Past appointments lists the previous appointment of the patients.

Documents: Patient can upload documents from here by clicking 'Upload' button. There are two sections like 'Shared documents' and 'Uploaded by me'. There is an option to search documents and  to sort the documents by Name as  A-Z , Z-A and Date as  Recent, Older.

Account details: Account details of responsible party and other members are shown here. Patients can edit their details , can add an account member and can add an insurance from this section.

Written by Geo Thomas | Last published at: August 19, 2021


Iris is the hub that brings together User Chat, Group Chat, Patient Texting, and In-Office Patient Tracking capabilities into one interface. It has the ability to launch as a separate pop-out browser window, so that users can switch between the main browser instance(with the PMS tabs) and the Iris window using Alt + Tab (in Windows).


Iris can be launched only from within CareStack after the user has logged in. When they log out of CareStack, they will be logged out of Iris too. Unified chat search is for searching across users/profiles/locations.

The office chat chat be accessed by clicking this icon.

Related image: ./carestack-questions-2023-03-02_files/1628885959764-1628885959764.png

It would have two options, one for text chat and the other for office chat.

Related image: ./carestack-questions-2023-03-02_files/1628888530199-1628888530199.png

Office Chat


It is used for in-office communications. 

Statuses

By default, while logging in, the status would be Active and after logging out, it would be Offline. The other available statuses are Busy and Away. The user can choose any status based on their availability

Related image: ./carestack-questions-2023-03-02_files/1628888604571-1628888604571.png

Search

The search option allows the user to search for any other user in their practice.

Related image: ./carestack-questions-2023-03-02_files/1628888643231-1628888643231.png

Chat Groups

Chat groups can be created by clicking Create Group. A maximum of 20 users can be added to a chat group.

Related image: ./carestack-questions-2023-03-02_files/1628887816783-1628887816783.png

Settings

The settings button gives two options, to mute a chat and to mark a chat as unread.

Related image: ./carestack-questions-2023-03-02_files/1628888675163-1628888675163.png

Alerts

While sending/receiving messages, IRIS produces a beep sound to alert the user. If desktop notifications are enabled in Chrome, a pop-up message would appear while receiving messages.

Text Chat


The text chat inside IRIS allows the user to send messages to patients. This is same as the text messaging feature inside CareStack.

Related image: ./carestack-questions-2023-03-02_files/1628888088620-1628888088620.png

The options available in IRIS text chat is same as that in the text messages in CareStack. That is, the user can search for any patient who has opted for text messages, can adjust the view of the chat as to show All messages, read messages or unread messages, can set the the location for which the messages are to be shown, etc

Written by Nidhin John | Last published at: October 03, 2022


Net Promoter Score (NPS) is a customer loyalty and satisfaction measurement taken from asking customers how likely they are to recommend your product or service to others on a scale of 0-10. Depending on the score customers/ clients provide, they can be classified as Promoters, Passives and Detractors.


Promoters: Clients who give a score of 9 or 10. They represent a company’s most enthusiastic and loyal customers: these people are likely to act as brand ambassadors, enhance a brand’s reputation, and increase referral flows, helping fuel the company's growth.


Passives: Clients who give a score of 7 or 8. They are not actively recommending a brand, but are also unlikely to damage it with negative word of mouth. Although they are not included in the NPS calculation, passives are very close to being promoters (particularly when they give a score of 8), so it always makes strategic sense to spend time investigating what to do to win them over.


Detractors: Clients who give a score between 0 to 6. They are unlikely to recommend a company or product to others, probably won’t stick around or repeat purchases, and—worse—could actively discourage potential customers away from a business.

NPS calculation

NPS is calculated by subtracting the percentage of Detractors from the percentage of Promoters. Percentage of promoters can be calculated by dividing the number of clients who gave a score of 9 or 10 to the total number of clients who gave some rating. Similarly the percentage of detractors can also be calculated.


   NPS = % of Promoters - % of Detractors

NPS can vary between -100 to +100. -100 is when all the clients are detractors, meaning, the score given by all clients are between 0 and 6. +100 is when all clients are promoters, meaning, the score given by all clients is either 9 or 10. Any score above zero is considered a good score.

Why is NPS important?

NPS can be used as a predictor of business growth. When your company’s NPS is high (or, at least, higher than the industry average), you know that you have a healthy relationship with customers who are likely to act as evangelists for the brand, fuel word of mouth, and generate a positive growth cycle.


NPS is a valuable metric on a strategic level, but by itself, the score is not enough to be useful or paint a complete picture. The overall NPS system is important because it allows businesses to: 

Current NPS workflow in CareStack

  1. New practice onboard to CareStack

  2. Each new CareStack user in a practice will get NPS feedback pop up after 60 days 

  3. After this NPS feedback is collected from all users every 90 days

  4. If the user click ”I will do it later’’ option, the pop up will appear each time the user log out

  5. The data collected is stored in database

  6. TOPS team share collected user feedback on a daily basis

  7. NPS report is prepared on a monthly basis



Related image: ./carestack-questions-2023-03-02_files/1643953383218-Feedback Modal.png


The image shown above is the feedback modal users see while they log out. As per the current workflow two things can happen after a user give a score.

  1. If the score is 8 or above, the user is directed to https://carestack.com/refer-a-practice/. Through this page a user can refer other practices to CareStack. If the user refer others to CareStack they are given vouchers and benefits.
  2. If the score is below 8, the user will be redirected to the login page.